Document Detail

Demonstration of Anatomical Reentrant Tachycardia Circuit in Verapamil-Sensitive Atrial Tachycardia Originating from the Vicinity of the Atrioventricular Node.
MedLine Citation:
PMID:  22583842     Owner:  NLM     Status:  Publisher    
BACKGROUND:: The anatomical location of reentry circuit in verapamil-sensitive atrial tachycardia originating from the vicinity of atrioventricular node (V-AT) is not well clarified. OBJECTIVE:: The purpose of this study was to define the reentry circuit of V-AT. METHODS:: In 17 patients with V-AT, rapid atrial pacing at a rate 5 beats/minute faster than the tachycardia rate was delivered from multiple sites of the right atrium (RA) during tachycardia to define the direction of the proximity of the slow conduction area of reentry circuit. After identification of manifest entrainment and orthodromic capture of the earliest atrial activation site (EAAS), radiofrequency energy was delivered starting at a site 2 cm away from the EAAS in the direction of pacing site. Radiofrequency energy application site was then gradually advanced toward EAAS until termination of tachycardia to define the entrance of the slow conduction area. RESULTS:: The EAAS was orthodromically captured by pacing delivered from one of the high antero-lateral RA (n=6), high postero-septal RA (n=9) and RA appendage (n=2). Radiofrequency energy delivery to the site, 10.1±2.8 mm away from EAAS, terminated V-AT immediately after the onset of delivery (2.9±1.0 sec). The successful ablation site located outside the Koch's triangle, being more distant from His bundle (HB) site than EAAS (12.4±2.9 vs. 6.4±1.9 mm, p<0.0001). CONCLUSION:: The reentry circuit of V-AT located outside the Koch's triangle. V-AT was eliminated by the radiofrequency energy delivered to the entrance of reentry circuit, which was more distant from HB site than EAAS, under the navigation of entrainment.
Hiroshige Yamabe; Ken Okumura; Kenji Morihisa; Junjiroh Koyama; Hisanori Kanazawa; Tadashi Hoshiyama; Hisao Ogawa
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-5-11
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-5-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012. Published by Elsevier Inc.
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto.
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