Introduction: Dual atrioventricular nodal nonreentrant tachycardia is a rare supraventricular arrhythmia caused by simultaneous conduction over fast and slow atrioventricular nodal pathways. Its leads to misdiagnosis, delayed recognition, and in some cases tachycardia-induced cardiomyopathy.
Methods: We conducted a systematic review and proportional meta-analysis of published studies reporting clinical characteristics, diagnostic findings, therapeutic strategies, and long-term outcomes in patients with electrophysiologically confirmed dual atrioventricular nodal nonreentrant tachycardia. Electronic databases were searched from inception to February 2025, and studies including ≥3 patients with at least three months of follow-up were eligible.
Results: Two studies comprising 20 patients met inclusion criteria. All patients underwent slow-pathway radiofrequency ablation, achieving 100% acute success. Long-term arrhythmia-free survival ranged from 94% to 100%, yielding a pooled proportion of 0.92 (95% CI 0.68–0.98). Three patients presented with tachycardia-induced cardiomyopathy, all of whom showed normalisation or marked improvement in left ventricular ejection fraction after ablation. No major procedural complications were reported.
Conclusion: Current evidence, though limited, demonstrates that slow-pathway ablation is a highly effective and safe treatment for dual atrioventricular nodal nonreentrant tachycardia, with reliable arrhythmia suppression and full reversibility of tachycardia-induced cardiomyopathy. Earlier recognition may prevent unnecessary treatments and delayed recovery.
