Document Detail

Demonstration of the exact anatomic tachycardia circuit in the fast-slow form of atrioventricular nodal reentrant tachycardia.
MedLine Citation:
PMID:  11551878     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The tachycardia circuit in the fast-slow form of atrioventricular nodal reentrant tachycardia (FS-AVNRT) has not been convincingly defined. METHODS AND RESULTS: To define the tachycardia circuit, single extrastimuli were delivered during FS-AVNRT to 9 intra-atrial sites in 12 patients: the His bundle (HB) site; the superior portion of the HB site (S-HB); 3 arbitrarily divided sites on the AV junction extending from the HB site to the coronary sinus ostium (CSOS) (sites S, M, and I); the superior, posterior, and posteroinferior portions of the CSOS (S-CSOS, P-CSOS, and PI-CSOS, respectively); and the CSOS. The inferior portion of coronary sinus ostium (I-CSOS), at which the earliest retrograde activation was observed, was excluded. At each site, the longest coupling interval of the single extrastimulus that reset the tachycardia and the subsequent return cycle was measured. The mean tachycardia cycle length was 370+/-55 ms. The longest coupling intervals at sites S-HB, HB, S, M, I, CSOS, S-CSOS, P-CSOS, and PI-CSOS were 328+/-53, 360+/-55, 358+/-55, 358+/-54, 360+/-55, 338+/-56, 323+/-54, 331+/-56, and 321+/-58 ms, respectively, and the subsequent return cycles were 408+/-58, 371+/-55, 370+/-55, 372+/-56, 370+/-55, 396+/-56, 411+/-60, 405+/-58, and 412+/-59 ms, respectively. The longest coupling intervals at sites HB, S, M, and I were longer than those at S-HB, CSOS, S-CSOS, P-CSOS, and PI-CSOS (P<0.0001). The return cycles at sites HB, S, M, and I did not differ from the tachycardia cycle length, whereas those at CSOS, S-CSOS, P-CSOS, and PI-CSOS were longer than the tachycardia cycle length (P<0.0001). CONCLUSIONS: The perinodal atrium extending from the HB site to the I-CSOS is an integral limb of the reentry circuit in FS-AVNRT.
H Yamabe; Y Shimasaki; O Honda; Y Kimura; Y Hokamura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  104     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-11     Completed Date:  2001-10-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1268-73     Citation Subset:  AIM; IM    
Division of Cardiology, Kumamoto City Hospital, Kumamoto, Japan.
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MeSH Terms
Aged, 80 and over
Atrioventricular Node / physiopathology*
Bundle of His / physiopathology
Catheter Ablation
Heart Atria / physiopathology
Heart Conduction System / physiopathology
Middle Aged
Tachycardia, Atrioventricular Nodal Reentry / physiopathology*,  surgery
Comment In:
Circulation. 2002 Apr 9;105(14):e80-1; author reply e80-1   [PMID:  11940558 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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