[Congenitally corrected transposition of the great arteries with coexisting stenosis of pulmonary trunk valve and ventricular septum defect in a 55-year-old woman--a case report]. / Wrodzone skorygowane przelozenie wielkich pni tetniczych wspólistniejace ze stenoza zastawki pnia plucnego i ubytkiem czesci bloniastej przegrody miedzykomorowej u 55-letniej kobiety.

Congenitally corrected transposition of the great arteries (CCTGA) is a rare cardiac malformation. This anomaly is characterised by atrioventricular as well as ventriculoarterial discordance. Isolated CCTGA may cause no symptoms until adult life. Most CCTGA cases with concomitant cardiac abnormalities are symptomatic and are therefore usually diagnosed in childhood. In the majority of patients, congestive heart failure secondary to right ventricular dysfunction occurring by the fifth or sixth decade enables diagnosis. We present an oligosymptomatic 55-year-old woman with corrected transposition of the great arteries and coexisting stenosis of pulmonary trunk valve and ventricular septum defect.

[QRS and cycle length alternans during atrioventricular nodal reentry tachycardia: case report]. / Zmiennosc ksztaltu zespolów QRS i dlugosci cyklu w nawrotnym czestoskurczu wezlowym. Opis przypadku.

A 23-year old man with paroxysmal, poorly tolerated and spontaneously terminating palpitations, was referred to our department for electrophysiological study. Burst pacing from high right atrium using a cycle length of 350 ms induced a slowfast atrioventricular nodal reentry tachycardia. We excluded the presence of accessory atrioventricular tracts. During tachycardia a constant alternans of QRS morphology and cycle length was observed. The cycle length alternans could be due to the presence of three nodal pathways and activation circulating in a figure-of-eight pattern using alternatively two slow pathways as the antegrade arm of the reentry loop. The alternans could also originate from altering decremental properties of a single slow pathway that changed its conduction properties with relation to the length of the preceding cycle. The QRS alternans occurred both during burst pacing and tachycardia. As it was related to the rate and the changing cycle length, we concluded that it could reflect aberration in intraventricular conduction.