The inferior displacement of the His bundle and fast pathway in a patient with common type atrioventricular nodal tachycardia: Three-dimensional computed tomography analysis.

A 66-year-old woman with palpitations was referred to our center for catheter ablation due to drug-refractory, common type atrioventricular nodal tachycardia (AVNRT). A selective slow pathway ablation was attempted. A fast junctional rhythm with transient ventriculoatrial block followed by transient prolongation of the A-H interval occurred immediately after the radiofrequency (RF) application at the coronary sinus ostium (CSOS) level. To assess the location of the fast pathway and His bundle, we sought to visualize the anatomy of the triangle of Koch (TOK) by three-dimensional computed tomography (CT).