Clinical Features and Sites of Ablation for Patients With Incessant Supraventricular Tachycardia From Concealed Nodofascicular and Nodoventricular Tachycardias

JACC. Clinical Electrophysiology
Frederick T HanMelvin Scheinman

Abstract

This study sought to describe the clinical features and sites of successful ablation for incessant nodofascicular (NF) and nodoventricular (NV) tachycardias. Incessant supraventricular tachycardias have been associated with tachycardia-induced cardiomyopathies and have been previously attributed to permanent junctional reciprocating tachycardias, atrial tachycardias, and atrioventricular nodal re-entrant tachycardias. Incessant concealed NF and NV tachycardias have not been described previously. Three cases of incessant concealed NF and NV re-entrant tachycardias were identified from 2 centers. The authors describe 3 cases with incessant supraventricular tachycardia resulting from NV (2 cases) and NF (1 case) pathways. Atrioventricular nodal re-entrant tachycardia was excluded by His synchronous premature ventricular complexes that either delayed or terminated the tachycardia. Ventricular pacing showed constant and progressive fusion in cases 1 and 3. In 2 cases, there was spontaneous initiation with a 1:2 response (cases 1 and 3); the presence of retrograde longitudinal dissociation or marked decremental pathway conduction in cases 1 and 3 sustains these tachycardias. The NV pathway was successfully ablated in the slow pathway...Continue Reading

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Citations

Aug 23, 2019·Journal of Cardiovascular Electrophysiology·Yuji WakamatsuYasuo Okumura
Nov 5, 2019·Pacing and Clinical Electrophysiology : PACE·Kurt S HoffmayerMelvin M Scheinman
Apr 15, 2020·Circulation. Arrhythmia and Electrophysiology·Ricardo Cardona-GuaracheMelvin M Scheinman
Dec 4, 2020·World Journal of Clinical Cases·Chao ZhuGui-Jian Zhou
Apr 11, 2021·Trends in Cardiovascular Medicine·Amjad M Abualsuod, John M Miller
Oct 5, 2021·Circulation. Arrhythmia and Electrophysiology·Mohan N ViswanathanMelvin M Scheinman

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