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Atypical Fast-Slow Atrioventricular Nodal Reentrant Tachycardia Incorporating a "Superior" Slow Pathway: A Distinct Supraventricular Tachyarrhythmia.
- Source :
-
Circulation . 1/12/2016, Vol. 133 Issue 2, p114-123. 10p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>The existence of an atypical fast-slow (F/S) atrioventricular nodal reentrant tachycardia (AVNRT) including a superior (sup) pathway with slow conductive properties and an atrial exit near the His bundle has not been confirmed.<bold>Methods and Results: </bold>We studied 6 women and 2 men (age, 74 ± 7 years) with sup-F/S-AVNRT who underwent successful radiofrequency ablation near the His bundle. Programmed ventricular stimulation induced retrograde conduction over a superior SP with an earliest atrial activation near the His bundle, a mean shortest spike-atrial interval of 378 ± 119 milliseconds, and decremental properties in all patients. sup-F/S-AVNRT was characterized by a long-RP interval; a retrograde atrial activation sequence during tachycardia identical to that over a sup-SP during ventricular pacing; ventriculoatrial dissociation during ventricular overdrive pacing of the tachycardia in 5 patients or atrioventricular block occurring during tachycardia in 3 patients, excluding atrioventricular reentrant tachycardia; termination of the tachycardia by ATP; and a V-A-V activation sequence immediately after ventricular induction or entrainment of the tachycardia, including dual atrial responses in 2 patients. Elimination or modification of retrograde conduction over the sup-SP by ablation near the right perinodal region or from the noncoronary cusp of Valsalva eliminated and confirmed the diagnosis of AVNRT in 4 patients each.<bold>Conclusions: </bold>sup-F/S-AVNRT is a distinct supraventricular tachycardia, incorporating an SP located above the Koch triangle as the retrograde limb, that can be eliminated by radiofrequency ablation. [ABSTRACT FROM AUTHOR]
- Subjects :
- *ABLATION techniques
*ARRHYTHMIA
*ATRIOVENTRICULAR node
*ELECTROPHYSIOLOGY
*TACHYCARDIA
*ADENOSINE triphosphate
*AMBULATORY electrocardiography
*CARDIAC catheterization
*CARDIAC pacing
*CATHETER ablation
*COMPARATIVE studies
*ELECTROCARDIOGRAPHY
*HEART conduction system
*HIS bundle
*PATIENT aftercare
*ISOPROTERENOL
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*EVALUATION research
*RETROSPECTIVE studies
*PHARMACODYNAMICS
*SUPRAVENTRICULAR tachycardia
*DIAGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 00097322
- Volume :
- 133
- Issue :
- 2
- Database :
- Academic Search Index
- Journal :
- Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 112542029
- Full Text :
- https://doi.org/10.1161/CIRCULATIONAHA.115.018443