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

Abstract

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

References

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Citations

Nov 3, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Kiyoshi OtomoYoshito Iesaka
Jun 9, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Hiroshige YamabeHisao Ogawa
Aug 11, 2006·Journal of Cardiovascular Electrophysiology·George D VeenhuyzenWilliam G Stevenson
Sep 22, 2006·Journal of Cardiovascular Electrophysiology·Atul Verma
Jul 30, 2014·Journal of Cardiovascular Electrophysiology·James E IpBruce B Lerman
Dec 29, 2010·Journal of Cardiovascular Disease Research·Wang Jun-HuaLuo Hui-Lan
Nov 20, 2016·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Demosthenes G KatritsisJack Rickard
Aug 2, 2013·Internal Medicine·Masakuni FujiiKazuhide Yamamoto
Sep 27, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Demosthenes G Katritsis
Mar 6, 2012·Pacing and Clinical Electrophysiology : PACE·George D VeenhuyzenL Brent Mitchell
Apr 25, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Demosthenes G Katritsis, Mark E Josephson
Nov 2, 2020·Indian Pacing and Electrophysiology Journal·Kumar NarayananPadmakumar Ea

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