Wide QRS tachycardia with ventriculoatrial dissociation in early postoperative aortic valve replacement period: an atypical nodal reentry presentation.

We report an atypical presentation of atrioventricular (AV) nodal reentry tachycardia with periods of ventriculoatrial Wenckebach and complete ventriculoatrial dissociation which appeared in a male patient in the postoperative period following aortic valve replacement and plication of Valsalva's posterior sinus. The context for the onset of this AV nodal reentry tachycardia and the concurrent electrophysiological findings support the hypothesis of a strictly nodal location of the circuit and suggest that the electrical modifications sustained by the perinodal region are the triggering agent for the reentry mechanism. Therefore, the AV nodal reentry is a mechanism that must be considered when tachycardia appears in the early postoperative period following aortic valve replacement.