Unique electrophysiologic characteristics of atrioventricular nodal reentrant tachycardia with different ventriculoatrial block patterns: effects of slow pathway ablation and insights into the location of the reentrant circuit

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Kiyoshi OtomoShiro Kamakura

Abstract

The electrophysiologic mechanisms of different ventriculoatrial (VA) block patterns during atrioventricular nodal reentrant tachycardia (AVNRT) are poorly understood. The purpose of this study was to characterize AVNRTs with different VA block patterns and to assess the effects of slow pathway ablation. Electrophysiologic data from six AVNRT patients with different VA block patterns were reviewed. All AVNRTs were induced after a sudden AH "jump-up" with the earliest retrograde atrial activation at the right superoparaseptum. Different VA block patterns comprised Wenckebach His-atrial (HA) block (n = 4), 2:1 HA block (n = 1), and variable HA conduction times during fixed AVNRT cycle length (CL) (n = 1). Wenckebach HA block during AVNRT was preceded by gradual HA interval prolongation with fixed His-His (HH) interval and unchanged atrial activation sequence. AVNRT with 2:1 HA block was induced after slow pathway ablation for slow-slow AVNRT with 1:1 HA conduction, and earliest atrial activation shifted from right inferoparaseptum to superoparaseptum without change in AVNRT CL. The presence of a lower common pathway was suggested by a longer HA interval during ventricular pacing at AVNRT CL than during AVNRT (n = 5) or Wenckebach ...Continue Reading

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Citations

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
Sep 7, 2012·Clinical Medicine Insights. Cardiology·Antoine Kossaify, Maya Zeeny
Jan 9, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Christopher M LoweryWilliam H Sauer
Nov 3, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Kiyoshi OtomoYoshito Iesaka
Aug 8, 2008·Pacing and Clinical Electrophysiology : PACE·Kiyoshi OtomoYoshito Iesaka
May 2, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Thomas Rostock, Stephan Willems
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Mar 13, 2020·Journal of Cardiovascular Electrophysiology·Shinsuke MiyazakiHiroshi Tada
Dec 19, 2020·Journal of Arrhythmia·Miguel A AriasCristina Martín-Sierra
Jan 4, 2022·Pacing and Clinical Electrophysiology : PACE·Shuntaro TamuraHideki Ishii

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