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Clinical presentation of ventricular-Hisian and ventricular-nodal accessory pathways.

Abstract：

BACKGROUND:Narrow QRS tachycardia or premature beat with bystander atrial activation or ventricular-atrial dissociation is an unusual arrhythmia that can present diagnostic and therapeutic challenges. When ventricular-atrial conduction is robust, these arrhythmias can be difficult to distinguish from atrioventricular nodal reentry. OBJECTIVE:The purpose of this study was to describe the electrophysiology characteristics, diagnostic maneuvers, and treatment of these types of arrhythmias in a series of 7 cases. METHODS:Standard multipolar recording and pacing electrodes were used during electrophysiology studies. Catheter ablation was performed using radiofrequency or cryoenergy. RESULTS:During electrophysiology studies, ventricular-nodal or ventricular-Hisian conducting pathways were demonstrated to be responsible for the arrhythmias in all 7 cases. Successful ablation of these pathways using radiofrequency energy was accomplished in 6 of the 7 cases. CONCLUSION:Ventricular-Hisian and ventricular-nodal associated tachyarrhythmias should be distinguished from typical forms of atrioventricular nodal reentrant tachycardia. Catheter ablation of these pathways can be successfully accomplished using mapping techniques described in our report.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Chung R,Wazni O,Dresing T,Chung M,Saliba W,Lindsay B,Tchou P

doi

10.1016/j.hrthm.2018.08.006

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

369-377

issue

3

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(18)30793-8

journal_volume

16

pub_type

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