51. Electroanatomically estimated length of slow pathway in atrioventricular nodal reentrant tachycardia
- Author
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Shuntaro Tamura, Takashi Iizuka, Tadashi Nakajima, Tadanobu Irie, Takafumi Iijima, Masaki Ota, Mio Tamura, Masahiko Kurabayashi, Yoshiaki Kaneko, and Akihiro Saito
- Subjects
Adult ,Male ,Tachycardia ,Bundle of His ,medicine.medical_specialty ,Koch’s triangle ,Radiofrequency ablation ,medicine.medical_treatment ,Atrioventricular node ,Catheter ablation ,law.invention ,law ,Internal medicine ,medicine ,Humans ,Tachycardia, Atrioventricular Nodal Reentry ,Atrioventricular nodal reentrant tachycardia ,business.industry ,Middle Aged ,Ablation ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Slow pathway ,Catheter Ablation ,Cardiology ,Female ,Original Article ,Electroanatomic mapping ,medicine.symptom ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,NODAL ,business ,Junctional rhythm - Abstract
The length of the slow pathway (SP-L) in atrioventricular (AV) nodal reentrant tachycardia (NRT) has never been measured clinically. We studied the relationship among (a) SP-L, i.e., the distance between the most proximal His bundle (H) recording and the most posterior site of radiofrequency (RF) delivery associated with a junctional rhythm, (b) the length of Koch’s triangle (Koch-L), (c) the conduction time over the slow pathway (SP-T), measured by the AH interval during AVNRT at baseline, and (d) the distance between H and the site of successful ablation (SucABL-L) in 26 women and 20 men (mean age 64.6 ± 11.6 years), using a stepwise approach and an electroanatomic mapping system (EAMS). SP-L (15.0 ± 5.8 mm) was correlated with Koch-L (18.6 ± 5.6 mm; R2 = 0.1665, P < 0.005), SP-T (415 ± 100 ms; R2 = 0.3425, P = 0.036), and SucABL-L (11.6 ± 4.7 mm; R2 = 0.5243, P < 0.0001). The site of successful ablation was located within 10 mm of the posterior end of the SP in 38 patients (82.6 %). EAMS-guided RF ablation, using a stepwise approach, revealed individual variations in SP-L related to the size of Koch’s triangle and AH interval during AVNRT. Since the site of successful ablation was also correlated with SP-L and was usually located near the posterior end of the SP, ablating anteriorly, away from the posterior end, is not a prerequisite for the success of ablation procedures.
- Published
- 2013