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Av reentrant

Patricia E Thomas, Scott L Macicek
BACKGROUND: Catheter ablation has been used to manage supraventricular arrhythmia in children since 1990. This article reviews the history of catheter ablation used to treat arrhythmia in children and discusses new frontiers in the field. We also address ablation in adult patients with a history of congenital heart disease (CHD) that was diagnosed and initially treated in childhood. METHODS: We conducted an evidence-based literature review to gather available data on ablation for supraventricular tachycardia in children and adult patients with CHD...
2016: Ochsner Journal
Jin Iwasawa, Shinsuke Miyazaki, Takamitsu Takagi, Hiroshi Taniguchi, Hiroaki Nakamura, Hitoshi Hachiya, Yoshito Iesaka
BACKGROUND: The exact circuit responsible for the atrioventricular (AV) nodal reentrant tachycardia (AVNRT) is still unknown. We evaluated the optimal slow pathway ablation area in patients with and without 2:1 AV conduction during the slow-fast AVNRT. METHODS: Among 207 consecutive patients with slow-fast AVNRT who underwent slow pathway ablation, 12 (5.8 %) patients who had 2:1 AV conduction during tachycardia (group A) were included. Fifty-nine patients without 2:1 AV conduction during tachycardia or a lower common pathway (group B) were included as a control group...
August 19, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Jeremy P Moore, Kevin M Shannon, Frank A Fish, Stephen P Seslar, Jason M Garnreiter, Ulrich Krause, Ronn E Tanel, Andrew A Papez, Thomas A Pilcher, Seshadri Balaji
BACKGROUND: Extracardiac total cavopulmonary connection (E-TCPC) is widely performed for single ventricle palliation, yet there is little experience with catheter ablation in this population. OBJECTIVES: We hypothesized that atrial tachycardia substrates after primary E-TCPC would be similar to those in other forms of congenital heart disease and that catheter ablation could be performed effectively using a primarily transconduit approach. METHODS: Catheter ablation characteristics of patients with E-TCPC from 9 centers were collected...
September 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Paula L S Eryazici, Mansour Razminia, Oliver D'Silva, Jaime R Chavez, Ferah D Ciftci, Marianne Turner, Theodore Wang, Terry A Zheutlin, Richard F Kehoe
PURPOSE: Cryothermal ablation (CTA) for atrioventricular nodal reentrant tachycardia (AVNRT) is considered safer than radiofrequency ablation (RFA) since it eliminates the risk of inadvertent AV block. However, it has not been widely adopted due to high late recurrence rate (LRR). In an effort to improve LRR, we evaluated a new approach to cryothermal mapping (CTM): "time to tachycardia termination" (TTT). METHODS: This single-center study had 88 consecutive patients who underwent CTA using TTT for AVNRT...
May 25, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Takahiko Kinjo, Shingo Sasaki, Masaomi Kimura, Shingen Owada, Daisuke Horiuchi, Kenichi Sasaki, Taihei Itoh, Yuji Ishida, Yoshihiro Shoji, Kimitaka Nishizaki, Yuichi Tsushima, Hirofumi Tomita, Ken Okumura
BACKGROUNDS: Postpacing interval (PPI) measured after entrainment pacing describes the distance between pacing site and reentrant circuit. However, the influential features to PPI remain to be elucidated. METHODS AND RESULTS: This study included 22 cases with slow/fast atrioventricular (AV) nodal reentrant tachycardia (AVNRT), 14 orthodromic AV reciprocating tachycardia (AVRT) using an accessary pathway, 22 typical atrial flutter (AFL), and 18 other macroreentrant atrial tachycardia (atypical AFL)...
August 2016: Journal of Cardiovascular Electrophysiology
Parikshit S Sharma, Karoly Kaszala, Alex Y Tan, Jayanthi N Koneru, Richard Shepard, Kenneth A Ellenbogen, Jose F Huizar
Similar to endless loop tachycardia (ELT), repetitive nonreentrant ventriculoatrial synchrony (RNRVAS) is a ventriculoatrial (VA) synchrony pacemaker-mediated arrhythmia. RNRVAS was first described in 1990 and can only occur in the presence of retrograde VA conduction and dual-chamber or cardiac resynchronization devices with tracking (P-synchronous ventricular pacing such as DDD, DDDR) or nontracking pacing modes that allow AV-sequential pacing (DDI, DDIR). RNRVAS is promoted by (1) high lower rate limit or any feature that allows rapid pacing, (2) long AV intervals, or (3) long postventricular atrial refractory period (PVARP)...
August 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Shailendra Upadhyay, Anne Marie Valente, John K Triedman, Edward P Walsh
BACKGROUND: Variability in atrioventricular (AV) node location in congenital heart disease (CHD) can make catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) challenging. OBJECTIVE: The purpose of this study was to describe institutional technique and outcomes for slow pathway modification in a cohort with CHD. METHODS: The study consisted of a retrospective review of CHD patients who underwent study from 2001 to 2013 with a diagnosis of AVNRT...
June 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Krishna Kumar Mohanan Nair, Narayanan Namboodiri, Anees Thajudeen, Nilesh Patel, Ajitkumar Valaparambil, Jaganmohan Tharakan
No abstract text is available yet for this article.
July 2016: Journal of Cardiovascular Electrophysiology
Christian von Bary, Lars Eckardt, Daniel Steven, Hans-Ruprecht Neuberger, Roland Richard Tilz, Hendrik Bonnemeier, Dierck Thomas, Thomas Deneke, Heidi L Estner, Malte Kuniss, Armin Luik, Philipp Sommer, Frederik Voss, Christian Meyer, D I Shin, Charalampos Kriatselis
The AV nodal reentrant tachycardia (AVNRT) is one of the most common arrhythmias encountered in clinical practice. It is characterized by a constant heart rate and an on/off phenomenon. The clinical symptoms may include palpitations, anxiety, polyuria, and dyspnea. Typically, tachycardia may be disrupted by vagal maneuvers in many patients. First-line treatment of symptomatic AVNRT is radiofrequency ablation. The present article deals with the characteristics, differential diagnosis and treatment of AVNRT in the EP lab...
December 2015: Herzschrittmachertherapie & Elektrophysiologie
Jorge Gonzalez, Moisés Levinstein, Pedro Brugada
Cryoablation is an energy alternative to radiofrequency for ablation of various arrhythmias, where its unique biophysical properties offer a greater safety profile. Since its first use for the surgical treatment of different arrhythmias until its conceptualization in the current technical transcatheter, cryoablation has proven not to be only a safe source of energy, but also an effective source in the long-term. While the radiofrequency has been the energy most used for isolation of pulmonary veins in atrial fibrillation ablation, technological advances in cryoballon have managed to simplify the procedure without sacrificing its effectiveness...
January 2016: Archivos de Cardiología de México
Warangkna Boonyapisit, Komsing Methavigul, Rungroj Krittayaphong, Charn Sriratanasathavorn, Satchana Pumprueg, Arisara Suwanagool, Arjbordin Winijkul, Krit Jongnarangsin
BACKGROUND: Postpacing interval (PPI) after right ventricular (RV) pacing entrainment minus tachycardia cycle length (TCL) with a correction for atrioventricular (AV) node delay (corrected PPI-TCL) was useful to differentiate atrioventricular node reentrant tachycardia (AVNRT) from orthodromic reciprocating tachycardia (ORT). However, the value of corrected PPI-TCL in determining the site of the accessory pathway (AP) in ORT has not been investigated. The purpose of this study was to assess whether the corrected PPI-TCL is useful in differentiating ORT using a left-sided AP from a right-sided AP...
February 2016: Pacing and Clinical Electrophysiology: PACE
Chirag R Barbhaiya, Saurabh Kumar, Samuel H Baldinger, Gregory F Michaud, William G Stevenson, Rodney Falk, Roy M John
BACKGROUND: Arrhythmias in cardiac amyloidosis (CA) result in significant comorbidity and mortality but have not been well characterized. OBJECTIVE: The purpose of this study was to define intracardiac conduction, atrial arrhythmia substrate, and ablation outcomes in a group of advanced CA patients referred for electrophysiologic study. METHODS: Electrophysiologic study with or without catheter ablation was performed in 18 CA patients. Findings and catheter ablation outcomes were compared to age- and gender-matched non-CA patients undergoing catheter ablation of persistent atrial fibrillation (AF)...
February 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Thorsten Lewalter
The differential diagnosis of a narrow QRS tachycardia requires on the one hand knowledge about the clinical data of the tachycardia patient but on the other hand a systematic step by step analysis of the electrocardiogram (ECG) is the most successful approach. Apart from the question of regularity or irregularity of the QRS complexes, the presence and detection of P waves is also of importance. The P wave timing in relation to the preceding and the following QRS complexes as well as the numerical relationship of P waves and QRS complexes allow a well-founded suspected diagnosis to be achieved in most cases...
September 2015: Herzschrittmachertherapie & Elektrophysiologie
Charitha D Reddy, Michael J Silka, Yaniv Bar-Cohen
BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) typically occurs in adolescents and adults with limited data regarding AVNRT in young children. METHODS: All patients with AVNRT who underwent electrophysiology study and ablation between 2005 and 2012 were retrospectively studied. Patients were stratified by age <10 years (young AVNRT) or ≥10 years (older AVNRT). Young AVNRT patients were also compared to age-matched patients with orthodromic reentrant tachycardia (ORT)...
November 2015: Pacing and Clinical Electrophysiology: PACE
Barbara Bellmann, Sebastian Reith, Christopher Gemein, Patrick Schauerte
We report the case of a 48-year-old woman with an orthotopic heart transplantation. Two years after transplantation, the patient reported intermittent palpitations and dyspnea. The results of the 12-lead electrogram provided suspicion of AV nodal reentrant tachycardia (AVNRT), which was confirmed in the electrophysiological examination. The AVNRT was successfully eliminated without complications by radiofrequency catheter ablation of the slow pathway. The case shows that an AVNRT, even with existing sinus rhythm of the original heart, can also occur on the transplanted heart and ablation is safe and feasible...
September 2015: Herzschrittmachertherapie & Elektrophysiologie
Béatrice Brembilla-Perrot, Maxime Bénichou, Alice Brembilla, Erwan Bozec, Sarah Dorlet, Jean Marc Sellal, Arnaud Olivier, Vladimir Manenti, Thibaut Villemin, Daniel Beurrier, Anne Moulin-Zinsch, Christian De Chillou, Nicolas Girerd
OBJECTIVES: To jointly study paroxysmal supraventricular tachycardia (SVT)-related adverse events (AE) and ablation-related complications, with specific emphasis on the predictors of SVT-related AE as well as their significance by investigating their association with long-term mortality. METHODS: 1770 patients were included, aged 6 to 97, with either atrioventricular nodal reentrant tachycardia (AVNRT) or orthodromic atrioventricular reciprocal tachycardia (AVRT) mediated by concealed accessory pathway, consecutively referred for SVT work-up in a tertiary care center...
November 15, 2015: International Journal of Cardiology
Ulrich Krause, David Backhoff, Sophia Klehs, Thomas Kriebel, Thomas Paul, Heike E Schneider
BACKGROUND: AV nodal reentrant tachycardia (AVNRT) is commonly encountered in pediatric patients. Definite treatment can be achieved by catheter ablation. The purpose of the study was to evaluate the efficacy and safety of AVNRT ablation focusing on children with a body weight ≤25 kg. PATIENTS AND RESULTS: Catheter ablation of AVNRT was attempted in 253 patients. Median age was 12.5 years; median body weight was 48.7 kg. 25 (9.9 %) children had a body weight ≤25 kg...
November 2015: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Pablo A Chiale, Adrián Baranchuk, Mario D González, Rubén A Sánchez, Hugo A Garro, Pablo A Fernández, Carlos Quiroga Avalos, Andres Enriquez, Marcelo V Elizari
BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) often terminate spontaneously, presumably due to changes in the electrophysiological properties of the reentrant circuit. However, the mechanism of spontaneous termination of these arrhythmias is incompletely understood. METHODS: We included 70 consecutive patients with reentrant supraventricular tachycardias (35 AVNRT, 35 AVRT) in whom the arrhythmia ended spontaneously during the electrophysiologic study...
July 15, 2015: International Journal of Cardiology
Kazunori Horie, Kiyoshi Otomo, Shumpei Mori, Yuichi Kikuchi, Taiichiro Meguro
An 81-year-old woman who had undergone dual chamber pacemaker implantation for sick sinus syndrome was referred to our hospital with drug-refractory common atrioventricular (AV) nodal reentrant tachycardia. Ventricular pacing (Vp) following premature atrial contraction (PAC) with a long AV interval induced ventriculoatrial (VA) conduction, which allowed the tachycardia to be initiated. The sensed AV interval was shortened to 80 ms, allowing Vp during the refractory period of VA conduction. Postventricular atrial refractory period was shortened to 180 ms to sense PACs with short coupling interval...
2015: Internal Medicine
Reginald T Ho
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...
April 2015: Current Treatment Options in Cardiovascular Medicine
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