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Demosthenes G Katritsis, Joseph E Marine, Fernando M Contreras, Akira Fujii, Rakesh Latchamsetty, Konstantinos C Siontis, George D Katritsis, Theodoros A Zografos, Roy M John, Laurence M Epstein, Gregory F Michaud, Elad Anter, Ali Sepahpour, Edward Rowland, Alfred E Buxton, Hugh Calkins, Fred Morady, William G Stevenson, Mark E Josephson
BACKGROUND: -Due to its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method is not established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT. METHODS: -We studied 2079 patients with AVNRT subjected to slow pathway ablation. In 113 patients, mean age 48.5±18.1 years, 68 female, atypical AVNRT or co-existent atypical and typical AVNRT without other concomitant arrhythmia was diagnosed...
October 17, 2016: Circulation
Juliana Filgueiras Medeiros, Fábio Martins Nardo-Botelho, Lara Cristina Felix-Bernardes, Lucas Hollanda-Oliveira, Lucas Bassolli de Oliveira-Alves, Ênia Lúcia-Coutinho, Cristiano Dietrich, Adriano Caixeta, Jose Marconi Almeida-de-Sousa, Ântonio Carlos-Carvalho, Cláudio Cirenza, Ângelo Amato Vicenzo-de-Paola
BACKGROUND AND AIMS: Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal supraventricular tachycardia (SVT) whose diagnosis can be strongly suspected based on the surface eletrocardiogram alone. The purpose of this study is to determine the diagnostic accuracy of several electrocardiographic (ECG) criteria for the prediction of AVNRT. METHODS: Between November 2010 and January 2014, a total of 256 patients who underwent electrophysiological testing (EP) with regular, paroxysmal and narrow QRS complex tachycardia were prospectively enrolled...
July 2016: Archives of Medical Research
Per Insulander, Hamid Bastani, Frieder Braunschweig, Nikola Drca, Göran Kennebäck, Jonas Schwieler, Jari Tapanainen, Mats Jensen-Urstad
AIMS: Cryoablation is an alternative method to radiofrequency ablation for treatment of atrioventricular nodal re-entrant tachycardia (AVNRT). This study investigates the long-term safety and efficacy of cryoablation in AVNRT. METHODS AND RESULTS: We studied 515 consecutive patients (317 women, mean age 50 years, range 13-89 years) undergoing a first cryoablation for AVNRT between 2003 and 2008. Ablations were performed with a 6-mm Freezor Xtra catheter. Six patients were acute failures; 494 out of 509 (97%) primarily successfully ablated patients were followed up for a mean of 7...
October 13, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Fabrizio Drago, Mario Salvatore Russo, Irma Battipaglia, Gino Grifoni, Massimo Stefano Silvetti, Romolo Remoli, Vincenzo Pazzano, Fabio Anselmo Saputo, Michele Ciani
AIMS: Transcatheter cryoablation is a well-established technique for the treatment of AV nodal reentry tachycardia (AVNRT) in children. Nevertheless, A-V nodal slow pathway conduction may recur after an acutely successful procedure. The aim of this study was to evaluate the long-term outcome of acutely successful AVNRT cryoablations in pediatric patients in case of focal cryolesion and in case of need for High Density Linear Lesion (HDLL) cryoablation due to focal failure. METHODS: ...
September 22, 2016: Pacing and Clinical Electrophysiology: PACE
Tamas Szili Torok, Lennart J DE Vries, Emin E Özcan, Can Hasdemir, Zsuzsanna Kis, Attila Kardos, Tamas Géczy, Istvan Kovacs, Imre Benedek, Erik Oosterwerff, Astrid A Hendriks, Muchtiar Khan, Sing-Chien Yap
BACKGROUND: Multiple mechanisms have been proposed for idiopathic premature ventricular contractions (PVCs) originating from the outflow tracts (OTs). Recent observations such as the coexistence of these arrhythmias with atrioventricular nodal reentrant tachycardias and the association between discrete prepotentials and successful ablation sites of ventricular arrhythmias (VAs) from the OTs suggest a common link. OBJECTIVE: In this case series we draw attention to a unique association between accessory pathways (APs) and idiopathic PVCs from the OTs, disappearing after AP ablation...
October 6, 2016: Journal of Cardiovascular Electrophysiology
Lichun Wang, Jingzhou Jiang, Chen Su, Chong Feng, Yili Chen, Jun Liu, Jiangui He, Anli Tang
PURPOSE: Differentiating between atrioventricular nodal reentrant tachycardia (AVNRT) and non-reentrant junctional tachycardia (JT) is difficult but highly necessary for catheter ablation. The purpose of this study was to investigate whether the ventriculoatrial (VA) relationship after atrial overdrive pacing (AOP) could help to distinguish AVNRT from JT. METHODS: Thirty-eight AVNRT and 21 JT patients who were induced by infusion of isoproterenol after successful AVNRT ablation were paced through the high right atrium or coronary sinus until the ventricles were constantly captured...
September 13, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Demosthenes G Katritsis, Mark E Josephson
Atrioventricular nodal reentrant tachycardia (AVNRT) should be classified as typical or atypical. The term 'fast-slow AVNRT' is rather misleading. Retrograde atrial activation during tachycardia should not be relied upon as a diagnostic criterion. Both typical and atypical atrioventricular nodal reentrant tachycardia are compatible with varying retrograde atrial activation patterns. Attempts at establishing the presence of a 'lower common pathway' are probably of no practical significance. When the diagnosis of AVNRT is established, ablation should be only directed towards the anatomic position of the slow pathway...
August 2016: Arrhythmia & Electrophysiology Review
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
Michal M Farkowski, Mariusz Pytkowski, Aleksander Maciag, Dominik Golicki, Ilona Kowalik, Marcin Czech, Piotr Rucinski, Hanna Szwed
PURPOSE: Radiofrequency ablation (RFA) is considered the treatment of choice in cases of atrioventricular nodal reciprocating tachycardia (AVNRT) and atrioventricular reciprocating tachycardia (AVRT). Published studies suggest a considerable time gap between the onset of the arrhythmia, correct diagnosis, and RFA which may reach 10-15 years. The cost of medical treatment during that period may be substantial. The aim of the study was to calculate the annual direct medical cost of medical treatment of patients with AVNRT and AVRT and identify potential factors influencing this cost...
August 3, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Béatrice Brembilla-Perrot, Arnaud Olivier, Thibaut Villemin, Julie Vincent, Vladimir Manenti, Daniel Beurrier, Arnaud Terrier de la Chaise, Olivier Selton, Pierre Louis, Christian de Chillou, Jean Marc Sellal
BACKGROUND: Atrial fibrillation (AF) and other supraventricular tachyarrhythmias (SVTA) [atrial flutter (AFL), atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT) and preexcitation syndrome (PS)] are frequently associated. We assessed the AF occurrence frequency and predictors according to the nature of SVTA and completion of SVTA ablation. METHODS AND RESULTS: 4169 patients were referred for SVTA (typical AVNRT: 1338, AVRT over a concealed accessory pathway: 329, atypical AVNRT: 205, AFL: 1321; PS: 976); mean age was 50±20years; electrophysiological study (EPS) was systematic; patients were followed for a mean duration of 3±4...
October 1, 2016: International Journal of Cardiology
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
Jacques Billette, Rafik Tadros
No abstract text is available yet for this article.
July 2016: Journal of Cardiovascular Electrophysiology
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
Demosthenes G Katritsis, Theodoros Zografos, George D Katritsis, Eleftherios Giazitzoglou, Vasilios Vachliotis, George Paxinos, Alan John Camm, Mark E Josephson
AIMS: To conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT). METHODS AND RESULTS: Patients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120-300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a 'pill in the pocket' approach...
May 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Ivan Zeljković, Ivica Benko, Šime Manola, Vjekoslav Radeljić, Nikola Pavlović
We report the case of a 46-year old patient in whom an electrophysiology study (EP) was performed due to paroxysmal supraventricular tachycardia documented in 12-lead ECG. During the EP study, supraventricular tachycardia was induced easily and it corresponded to orthodromic AV reentry tachycardia (AVRT) using a concealed left free wall accessory pathway. However, during the study AVRT spontaneously and repeatedly converted to the typical slow-fast AV node reentry tachycardia (AVNRT). Both accessory and AV nodal slow pathways were ablated, due to the finding that both AVRT and AVNRT were independently inducible during the EP study...
September 2015: Indian Pacing and Electrophysiology Journal
Felix K Wegner, Maria Silvano, Nils Bögeholz, Patrick R Leitz, Gerrit Frommeyer, Dirk G Dechering, Stephan Zellerhoff, Simon Kochhäuser, Philipp S Lange, Julia Köbe, Kristina Wasmer, Gerold Mönnig, Lars Eckardt, Christian Pott
BACKGROUND: Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown. METHODS: Out of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs...
March 25, 2016: Journal of Cardiology
Marwan M Refaat, Melvin Scheinman, Nitish Badhwar
This article presents a diagnostic dilemma in which atrioventricular nodal reentrant tachycardia (AVNRT) and junctional tachycardia (JT) were differentiated based on tachycardia initiation with atrial extrastimulus as well as on the response to progressive decremental atrial extrastimuli. The progressive increase in A2H2' and H2H2' in response to atrial extrastimuli favors reentry as the mechanism of the tachycardia. This is a novel mechanistic differentiation of AVNRT from focal JT.
March 2016: Cardiac Electrophysiology Clinics
Frederick T Han
Junctional tachycardia (JT) is rare cause of supraventricular tachycardia. The intracardiac activation sequence is similar to atrioventricular nodal reentrant tachycardia (AVNRT). Premature atrial contractions inserted during tachycardia can help distinguish JT from AVNRT. As noted in this case, slow pathway ablation for JT may not always be effective for termination of JT. Activation mapping during JT identified a low-amplitude potential in the region of the coronary sinus ostium and the inferior margin of the triangle of Koch that marked the successful ablation site for JT...
March 2016: Cardiac Electrophysiology Clinics
Jason See, Jonah L Amora, Sheldon Lee, Paul Lim, Wee Siong Teo, Boon Yew Tan, Kah Leng Ho, Chee Wan Lee, Chi-Keong Ching
INTRODUCTION: The use of non-fluoroscopic systems (NFS) to guide radiofrequency catheter ablation (RFCA) for the treatment of supraventricular tachycardia (SVT) is associated with lower radiation exposure. This study aimed to determine if NFS reduces fluoroscopy time, radiation dose and procedure time. METHODS: We prospectively enrolled patients undergoing RFCA for SVT. NFS included EnSiteTM NavXTM or CARTO® mapping. We compared procedure and fluoroscopy times, and radiation exposure between NFS and conventional fluoroscopy (CF) cohorts...
July 2016: Singapore Medical Journal
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
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