Abstract
Long RP tachycardias are a unique collection of arrhythmias that include atypical (fast-slow) atrio-ventricular nodal reentrant tachycardia (AVNRT) with and without a concealed, bystander nodo-fascicular/ventricular accessory pathway (AP), orthodromic reciprocating tachycardia (ORT) using a concealed, slowly conducting, and decremental atrio-ventricular (AV) AP (PJRT), ORT using a concealed nodo-fascicular/ventricular AP (NFRT), and atrial tachycardia (AT)-all but the last being dependent upon the AV node. These tachycardias respond differently to pacing maneuvers than their short RP counterparts and can manifest: (1) both true and pseudo-AAV responses, (2) long uncorrected and corrected post-pacing intervals, (3) prolonged delta ventriculo-atrial (∆VA) and delta His bundle-atrial (∆HA) values, and (4) resetting with delay. Diagnosis requires analysis of available clues from spontaneous transition zones as well as atrial and ventricular pacing maneuvers to delineate the upper and lower limbs of each circuit, respectively. Establishing the exact mechanism of tachycardia is important for safe and successful ablation. With activation mapping to localize AT or the AV AP of ORT and slow pathway (SP) ablation of atypical AVNRT and NF...Continue Reading
References
Jul 30, 1992·The New England Journal of Medicine·W M JackmanM I Prior
Jul 1, 1987·Circulation·B B LermanJ P DiMarco
Apr 15, 1985·The American Journal of Cardiology·G H BardyJ J Gallagher
Mar 1, 1994·Circulation·J D Martínez-AldayJ L Delcán
Mar 15, 1993·Journal of the American College of Cardiology·C M TracyD Mukherjee
Sep 1, 1995·Journal of Cardiovascular Electrophysiology·K C ManF Morady
Sep 1, 1996·Circulation·K HiraoW M Jackman
Apr 1, 1996·Pacing and Clinical Electrophysiology : PACE·H YamabeH Yasue
Mar 18, 1999·Journal of the American College of Cardiology·B P KnightF Morady
Oct 5, 2001·Journal of the American College of Cardiology·G F MichaudF Morady
Dec 18, 2003·Journal of Cardiovascular Electrophysiology·Vivek Y ReddyJeremy N Ruskin
May 30, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Esteban González-TorrecillaJesús Almendral
Nov 4, 2006·Journal of Cardiovascular Electrophysiology·Uwais MohamedGeorge J Klein
Jan 9, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T HoArnold J Greenspon
Feb 21, 2008·Journal of Cardiovascular Electrophysiology·Eugene S RhimReginald T Ho
Mar 28, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Oliver R SegalGeorge J Klein
Feb 5, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Mithilesh Kumar DasDeepak Bhakta
Jul 20, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Gopi DandamudiJohn M Miller
Oct 26, 2010·Circulation. Arrhythmia and Electrophysiology·Soufian T AlMahameedGregory F Michaud
Jun 4, 2011·Circulation. Arrhythmia and Electrophysiology·Matthew T BennettGeorge J Klein
Sep 21, 2011·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T Ho, Jeffrey Luebbert
Mar 24, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T Ho, Behzad B Pavri
Jun 20, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T Ho, Steven A Levi
May 1, 2013·Circulation. Arrhythmia and Electrophysiology·Reginald T HoArnold J Greenspon
Aug 6, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Reginald T Ho, Andrew Yin
Jan 24, 2014·Journal of Cardiovascular Electrophysiology·Anand S KeniaBehzad B Pavri