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Electrophysiologic delineation of the tachycardia circuit in the slow-slow form of atrioventricular nodal reentrant tachycardia.

Abstract：

BACKGROUND:Little is known about the exact boundaries of the reentrant circuit in the slow-slow form of atrioventricular nodal reentrant tachycardia (AVNRT). OBJECTIVE:The purpose of this study was to examine the tachycardia circuit in the slow-slow form of AVNRT. METHODS:Single extrastimuli were delivered during the slow-slow form of AVNRT at 10 sites along the right interatrial septum: superior portion of the His-bundle (HB) site, the HB site, three equidistantly divided sites of the AV junction between HB site and coronary sinus ostium (CSOS; sites S, M, and I), and inferior, superior, posterior, posteroinferior, and internal portions of the CSOS in 13 patients. The longest coupling interval of a single extrastimulus that reset the tachycardia and the following return cycle were measured. RESULTS:The tachycardia cycle length was 409 +/- 50 ms. The earliest atrial electrogram during tachycardia was observed at site I in all patients. The longest coupling intervals at superior-HB, HB site, sites S, M, and I, and inferior-CSOS, superior-CSOS, posterior-CSOS, posteroinferior-CSOS, and internal-CSOS were 340 +/- 52, 355 +/- 50, 367 +/- 50, 378 +/- 51, 398 +/- 49, 398 +/- 52, 355 +/- 60, 351 +/- 50, 371 +/- 48, and 363 +/- 54 ms, respectively. The following return cycles were 468 +/- 52, 453 +/- 52, 442 +/- 52, 431 +/- 50, 411 +/- 52, 410 +/- 49, 454 +/- 45, 457 +/- 57, 438 +/- 54, and 445 +/- 53 ms, respectively. The longest coupling intervals at site I and inferior-CSOS were significantly longer than those at the other sites (P <.0001). The return cycles at site I and inferior-CSOS did not differ from the tachycardia cycle length, whereas those at the other sites were significantly longer than the tachycardia cycle length (P <.0001). CONCLUSION:Site I and inferior-CSOS are involved in the slow-slow form of AVNRT circuit, and the atrial tissue between those sites form an integral limb of the reentrant circuit.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Yamabe H,Tanaka Y,Morihisa K,Uemura T,Kawano H,Nagayoshi Y,Kojima S,Ogawa H

doi

10.1016/j.hrthm.2007.02.010

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

713-21

issue

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(07)00152-X

journal_volume

pub_type

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Electrophysiologic delineation of the tachycardia circuit in the slow-slow form of atrioventricular nodal reentrant tachycardia.