Document Detail

Unifying Mechanism of Sustained Idiopathic Atrial and Ventricular Annular Tachycardia.
MedLine Citation:
PMID:  24837827     Owner:  NLM     Status:  Publisher    
BACKGROUND: -Based on current understanding of cardiac conduction system development and the observation that arrhythmogenic foci can originate in areas near the atrioventricular annuli, we hypothesized that focal annular tachycardias, whether atrial or ventricular, share a common mechanism. We therefore prospectively evaluated this hypothesis in patients with sustained atrial and ventricular tachycardia originating from the peri-tricuspid and mitral annuli.
METHODS AND RESULTS: -Forty-nine consecutive patients with sustained, focal annular tachycardia comprise the study group. All underwent electrophysiologic evaluation and the mode of tachycardia initiation, termination, sensitivity to catecholamine infusion and response to adenosine/verapamil were evaluated. Electroanatomical activation maps identified the sites of arrhythmia origin. Tachycardias could be initiated and/or terminated with programmed stimulation in 46/46 patients and most (70%) were catecholamine facilitated. Of the 9 patients with sustained annular VT, 3 were localized to the tricuspid annulus, and 6 to the mitral annulus. All 9 VTs (100%) terminated with adenosine, 2/2 terminated with verapamil, and 2/2 terminated with Valsalva. Of the 40 patients with annular AT, 4 tachycardias were localized to the mitral annulus and 37 to the tricuspid annulus (including 9 para-Hisian), and all were adenosine-sensitive.
CONCLUSIONS: -Peri-annular atrial and ventricular tissue correspond to a region enriched with arrhythmogenic foci, which may reflect to a common developmental origin. Furthermore, the sensitivity of these tachycardias to adenosine provides evidence for a shared arrhythmia mechanism, consistent with intracellular calcium overload and triggered activity.
James E Ip; Christopher F Liu; George Thomas; Jim W Cheung; Steven M Markowitz; Bruce B Lerman
Related Documents :
2276757 - Noninvasive detection of coronary stenoses before and after angioplasty using eigenvect...
24827797 - How to recognize epicardial origin of ventricular tachycardias?
11174977 - Prediction of the third and fourth heart sounds by doppler echocardiography.
24381737 - When to go epicardially during ventricular tachycardia ablation? role of surface electr...
9161747 - Concurrent subarachnoid haemorrhage and myocardial injury.
17250647 - Acute coronary ligation in the dog induces time-dependent transitional changes in mitoc...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-17
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  -     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

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

Previous Document:  Engaging the Underserved: A Process Model to Mobilize Rural Community Health Coalitions as Partners ...
Next Document:  Population pharmacokinetic-pharmacodynamic modelling of mycophenolic acid in paediatric renal transp...