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Dirk G Dechering, Ruben Schleberger, Eva Greiser, Jannis Dickow, Julia Koebe, Gerrit Frommeyer, Stephan Willems, Lars Eckardt, Boris A Hoffmann, Kristina Wasmer
PURPOSE: Slow pathway modulation is the treatment of choice in patients with atrioventricular nodal reentrant tachycardia (AVNRT). No comparative data on ablation strategies exist. Therefore, we sought to compare two common ablation approaches. METHODS: We analyzed prospective ablation databases of two high-volume tertiary centers (> 1000 ablations/year) using either 30 or 50 W for slow pathway modulation from 2012 to 2013. We analyzed procedural characteristics as well as short- and long-term outcomes...
March 19, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Demosthenes G Katritsis, Roy M John, Rakesh Latchamsetty, Rahul G Muthalaly, Theodoros Zografos, George D Katritsis, William G Stevenson, Igor R Efimov, Fred Morady
BACKGROUND: Immunohistochemistry studies suggest that the anatomic substrate of the slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT) is the left inferior nodal extension. We hypothesized that slow pathway ablation from the left septum is an effective alternative to right-sided ablation. METHODS AND RESULTS: We analyzed our databases of AVNRT in search of cases that had used slow pathway ablation from the left septum because of failure of right septal ablation, and then prospectively subjected consenting patients to a left septal-only procedure...
March 2018: Circulation. Arrhythmia and Electrophysiology
Andrés Alonso-García, Felipe Atienza, Pablo Ávila, Clara Ugueto, Miriam Centeno, Reyes Álvarez, Tomás Datino, Esteban González-Torrecilla, Evaristo Castellanos, Gerard Loughlin, Constancio Medrano, Ángel Arenal, Francisco Fernández-Avilés
INTRODUCTION AND OBJECTIVES: Catheter ablation has become the treatment of choice in an increasing number of arrhythmias in children and adolescents. There is still limited evidence of its use at a national level in Spain. The aim was to describe the characteristics and results of a modern monocentric series form a referral tertiary care centre. METHODS: Retrospective register of invasive procedures between 2004 and 2016 performed in patients under 17 years and recorded clinical characteristic, ablation methodology and acute and chronic results of the procedure...
February 23, 2018: Revista Española de Cardiología
Hidekazu Kondo, Tetsuji Shinohara, Toyokazu Otsubo, Miho Miyoshi, Akira Fukui, Takeshi Tsuchiya, Naohiko Takahashi
Atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal re-entrant tachycardia (AVNRT) can coexist and present unidirectional transition (from AVRT to AVNRT, or from AVNRT to AVRT) in a single patient. Actually, such cases have already been reported previously. However, a case with spontaneous bidirectional transition of both tachycardias during supraventricular tachycardia has never been reported. This article describes a case with spontaneous, mutual, and frequent transition between AVRT and AVNRT...
February 3, 2018: Journal of Electrocardiology
Katie A Walsh, Joseph Galvin, John Keaney, Edward Keelan, Gabor Szeplaki
AIMS: Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs). METHODS: We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center...
February 23, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Janusz Sledz, Michal Labus, Mariusz Mazij, Monika Klank-Szafran, Dariusz Karbarz, Bartosz Ludwik, Jacek Kusa, Karol Deutsch, Leslaw Szydlowski, Adrian Mscisz, Jerzy Spikowski, Aleksandra Morka, Tomasz Kameczura, Aleksandra Swietoniowska-Mscisz, Sebastian Stec
PURPOSE: During incremental atrial pacing in patients with atrioventricular nodal reentrant tachycardia, the PR interval often exceeds the RR interval (PR > RR) during stable 1:1 AV conduction. However, the PR/RR ratio has never been evaluated in a large group of patients with pacing from the proximal coronary sinus and after isoproterenol challenge. Our study validates new site of pacing and easier method of identification of PR > RR. MATERIAL AND METHODS: A prospective protocol of incremental atrial pacing from the proximal coronary sinus was carried out in 398 patients (AVNRT-228 and control-170)...
February 10, 2018: Advances in Medical Sciences
Matthew B Ambrose, Jennifer N Avari Silva, Michael Rudokas, Tammy M Bowman, Joshua Murphy, George F Van Hare
PURPOSE: The anatomic basis of atrioventricular node reentrant tachycardia (AVNRT) remains incompletely characterized in children. Differences in coronary sinus (CS) size and morphology have been observed in adults with AVNRT but have not been well characterized in children. METHODS: Children (< 18 years) brought to the EP lab with supraventricular tachycardia for ablation underwent CS venography. A blinded pediatric interventional cardiologist performed CS measurements, which were indexed to body surface area...
February 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Laura Andreasen, Gustav Ahlberg, Chuyi Tang, Charlotte Andreasen, Jacob P Hartmann, Jacob Tfelt-Hansen, Elijah R Behr, Steen Pehrson, Stig Haunsø, LuCamp, Peter E Weeke, Thomas Jespersen, Morten S Olesen, Jesper H Svendsen
Atrioventricular nodal reentry tachycardia (AVNRT) is the most common form of regular paroxysmal supraventricular tachycardia. This arrhythmia affects women twice as frequently as men, and is often diagnosed in patients <40 years of age. Familial clustering, early onset of symptoms and lack of structural anomaly indicate involvement of genetic factors in AVNRT pathophysiology. We hypothesized that AVNRT patients have a high prevalence of variants in genes that are highly expressed in the atrioventricular conduction axis of the heart and potentially involved in arrhythmic diseases...
February 2, 2018: European Journal of Human Genetics: EJHG
Kaveh Hosseini, Mansour Jahangiri, Ali Vasheghani Farahani
Background: Brugada syndrome (BrS) is an inherited channelopathy, which is associated with sudden cardiac death due to rapid polymorphic VT or VF. There is no definite consensus regarding the management of asymptomatic patients. Some experts advocate close follow-up; others propose the programmed stimulation for risk stratification. We aimed to evaluate the benefit of complete atrial and ventricular stimulation in patients with BrS and palpitation. Case Presentation: A 30-year-old man was admitted to our hospital because of a family history of sudden cardiac death (SCD) at age less than 45 years...
2018: Caspian Journal of Internal Medicine
X M Li, H Y Ge, X Q Liu, L Shi, B J Guo, M T Li, H Jiang, Y Zhang, H J Liu, X C Zheng, A J Li, Y Y Zhang
Objective: The study assessed the clinical characteristics and response to acute intravenous antiarrhythmic drug therapy of supraventricular tachycardia (SVT) in children. Methods: This was a multicenter prospective descriptive study including 257 children from First Hospital of Tsinghua University, Peking University First Hospital, Children's Hospital Affiliated to Capital Institute of Pediatrics and Beijing Anzhen Hospital who received intravenous antiarrhythmic drug therapy for SVT from July 2014 to February 2017...
January 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Mehmet Karacan, Nida Çelik, Celal Akdeniz, Volkan Tuzcu
BACKGROUND: Atrioventricular nodal reentrant tachycardia (AVNRT) is a common tachyarrhythmia substrate in children, which is successfully treated by catheter ablation using radiofrequency or cryothermal energy. In recent years, cryoablation (Cryo) using electroanatomical system guidance is more commonly preferred for use in children in order to decrease the risk of an atrioventricular block. However, there are concerns regarding the long-term efficacy of Cryo in treating AVNRT. We aimed to evaluate the feasibility, safety, and long-term efficacy of Cryo for AVNRT in children...
January 9, 2018: Pacing and Clinical Electrophysiology: PACE
Myung Chul Hyun
Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Methods: We reviewed the records of 50 pediatric AVNRT patients who had undergone radiofrequency catheter ablation (RFCA) between January 1998 and December 2016 at a single regional center...
December 2017: Korean Journal of Pediatrics
David Calvo, Diego Pérez, José Rubín, Daniel García, Pablo Ávila, F Javier García-Fernández, Marta Pachón, Loreto Bravo, Jesús Hernández, Ángel L Miracle, Irene Valverde, Mar Gozalez-Vasserot, Miguel Ángel Árias, Javier Jimenez-Candíl, César Morís
Aims: Tachycardia mediated by septal accessory pathways (AP) and atypical atrioventricular nodal re-entry (AVNRT) require careful electrophysiologic evaluation for differential diagnosis. We aim to describe the differential behaviour of local ventriculo-atrial (VA) intervals which predicts the tachycardia mechanism. Methods and results: The local VA intervals at the para-Hisian septum were measured under three different situations: (i) tachycardia; (ii) sustained entrainment from the right ventricular apex (RVA); and (iii) continuous pacing from the RVA during sinus rhythm...
January 2, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Sarah Brubaker, Brit Long, Alex Koyfman
BACKGROUND: Atrioventricular-nodal-reentry tachycardia (AVNRT) is a form of supraventricular tachycardia (SVT) that is relatively common in the emergency department (ED). It is rarely indicative of underlying electrical or structural pathology. OBJECTIVE: This review evaluates the literature and controversies concerning treatment of AVNRT in the ED. DISCUSSION: For treatment of narrow-complex tachycardia, Advanced Cardiovascular Life Support guidelines recommend the use of vagal maneuvers, followed by adenosine...
November 24, 2017: Journal of Emergency Medicine
Anandaroop Lahiri, Sirish Chandra Srinath, David Chase, John Roshan
No abstract text is available yet for this article.
November 2017: Indian Pacing and Electrophysiology Journal
Muthiah Subramanian, M S Harikrishnan, Mukund A Prabhu, Praveen G Pai, Saritha S Shekhar, Kumaraswamy Natarajan
Multiple reports of familial clustering suggest that genetic factors may contribute in the pathogenesis of atrioventricular nodal re-entrant tachycardia (AVNRT). We report three cases of AVNRT in a father and his two sons along with a review of literature of other similar cases. Electrophysiological studies induced typical AVNRT, which was successfully eliminated by radiofrequency ablation in all of them. Of the 22 reported cases, 96% had typical (slow-fast) variant of AVNRT. The predominant pattern of inheritance appears to be autosomal dominant, though other patterns may exist...
November 2017: Indian Pacing and Electrophysiology Journal
Nikolaos Fragakis, Lydia Krexi, Panagiota Kyriakou, Melani Sotiriadou, Charalambos Lazaridis, Athanasios Karamanolis, Panagiotis Dalampyras, Stelios Tsakiroglou, Vassilios Skeberis, Dimitrios Tsalikakis, Vassilios Vassilikos
BACKGROUND: Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo-atrial (VA) conduction. METHODS: We analyzed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤ 70 years and 26 > 70 years. We analyzed the interval between the atrial electrogram in the His-bundle position and the distal ablation catheter [A(H)-A(RFd)] and between the distal ablation catheter and the proximal coronary sinus catheter [A(RFd)-A(CS)] before RF applications with and without JB...
January 2018: Pacing and Clinical Electrophysiology: PACE
Iskra H Bayraktarova, Milko K Stoyanov, Boyan T Kunev, Tchavdar N Shalganov
PURPOSE: To study the correlation between the sudden prolongations of the atrio-Hisian (AH) interval with ≥50 ms during burst and programmed atrial stimulation, and to define whether the AH jump during burst atrial pacing is a reliable diagnostic criterion for dual AV nodal physiology. METHODS: Retrospective data on 304 patients with preliminary ECG diagnosis of AV nodal reentrant tachycardia (AVNRT), confirmed during electrophysiological study, was analyzed for the presence of AH jump during burst and programmed atrial stimulation, and for correlation between the pacing modes for inducing the jump...
November 26, 2017: Indian Pacing and Electrophysiology Journal
J J Xu, L J Gao, D Chang, X J Xiao, R F Zhang, J Lin, Z M Zhao, H Zhang, Y L Xia, X M Yin, Y Z Yang
Objective: To compare the outcome of radiofrequency catheter ablation under local anesthesia/sedation (S) or general anesthesia(GA) in atrial fibrillation patients. Methods: Data of 498 patients with atrial fibrillation undergoing radiofrequency catheter ablation in our departmentfrom January 2014 to December 2015 were retrospectively analyzed. Two hundred and twenty patients assigned to the GA group, the other 278 patients to the S group. Patients were followed clinically every 3 months within one year after procedure...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
Felix Konrad Wegner, Nils Bögeholz, Patrick Leitz, Gerrit Frommeyer, Dirk Georg Dechering, Simon Kochhäuser, Philipp Sebastian Lange, Julia Köbe, Kristina Wasmer, Gerold Mönnig, Lars Eckardt, Christian Pott
BACKGROUND: The first-line therapy for atrioventricular nodal reentry tachycardia (AVNRT) is catheter-based slow pathway modulation. If AVNRT is not inducible during an electrophysiological study, an empirical slow pathway modulation (ESPM) may be considered in patients with dual atrioventricular nodal physiology and/or a typical electrocardiogram (ECG). METHODS: We screened 149 symptomatic patients who underwent ESPM in our department between 1993 and 2013. All patients fulfilled the following criteria: (1) either dual atrioventricular nodal (AVN) physiology with up to 2 AVN echo beats or characteristic ECG documentation or both, (2) noninducibility of AVNRT by programmed stimulation, and (3) completion of a telephone questionnaire for long-term follow-up...
November 2017: Clinical Cardiology
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