Mar 15, 2006

Left atrionodal connections in typical and atypical atrioventricular nodal reentrant tachycardias: activation sequence in the coronary sinus and results of radiofrequency catheter ablation

Journal of Cardiovascular Electrophysiology
Gi-Byoung NamYou-Ho Kim


The presence of atrionodal connections and coronary sinus (CS) breakthrough in atrioventricular nodal reentrant tachycardia (AVNRT) has been suggested. However, the incidence, anatomic relationship with reentrant circuit, and results of catheter ablation are unknown. Fifty-two patients with typical slow/fast AVNRT and 10 patients with atypical slow/intermediate or fast/slow AVNRT were included. Eccentric activation of the CS (EACS) was observed in 3 of 52 patients with typical and 8 of 10 patients with atypical AVNRT. The earliest CS activation in patients with an EACS was recorded at a site 10-20 mm inside the CS ostium. The postpacing interval after transient entrainment at the proximal CS in patients with EACS was 23 +/- 21 msec longer than the pacing cycle length. Modification or ablation of the slow pathway was successful in all patients with typical slow/fast AVNRT and in 7 of 9 patients with atypical AVNRT by RF energy delivered at the right septal tricuspid annulus (TA). In 2 patients with atypical AVNRT and an EACS, RF delivery inside the CS targeting the earliest CS activation eliminated the sustained AVNRT. Eccentric coronary sinus activation is observed in some rare cases of typical AVNRT, and in a majority of atypi...Continue Reading

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Mentioned in this Paper

Coronary Sinus Structure
Sinus Node Artery
NODAL gene
Heart Atrium
Catheter Ablation, Transvenous
Structure of Anulus Fibrosus of Tricuspid Orifice
Entire Coronary Sinus
Entire Anulus Fibrosus of Tricuspid Orifice
Coronary Heart Disease

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