Electrophysiologic significance of discrete slow potentials in dual atrioventricular node physiology: implications for selective radiofrequency ablation of slow pathway conduction

American Heart Journal
Kuo C-TR J Sung

Abstract

Atrioventricular (AV) node reentrant tachycardia is now routinely cured by selective radiofrequency ablation of slow AV node pathway conduction. However, debate remains concerning the optimum method for localizing the site at which radiofrequency energy should be delivered to eliminate slow-pathway conduction. Some investigators have proposed simple anatomy-guided ablations posteriorly near the ostium of the coronary sinus, whereas others suggest an electrophysiology-guided ablation using either recorded "slow potentials" or mapping of the retrograde atrial exit site of slow AV note pathway conduction when possible. To examine these issues, we systematically studied slow potentials recorded in the AV junction of patients undergoing radiofrequency catheter ablation for medically refractory AV node reentrant tachycardia. In 67 patients with the slow-fast form of AV note reentrant tachycardia, we performed detailed atrial mapping along the tricuspid annulus within the triangle of Koch. Two types of slow potentials were identified. Low-amplitude, low-frequency potentials, found in 48% of patients, were localized to the mid to posterior portions of the triangle of Koch, whereas high-amplitude, high-frequency potentials, observed in ...Continue Reading

References

Oct 1, 1975·British Heart Journal·P DenesK M Rosen

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Citations

Nov 14, 1997·Pacing and Clinical Electrophysiology : PACE·M HaïssaguerreJ Clémenty
Oct 6, 2004·Pacing and Clinical Electrophysiology : PACE·Kuo-Hung LinYing-Shiung Lee
Jun 26, 2007·Circulation Journal : Official Journal of the Japanese Circulation Society·Yasuaki TanakaHisao Ogawa

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