Differential Diagnosis of Slow/Slow Atrioventricular Nodal Reentrant Tachycardia from Atrioventricular Reentrant Tachycardia Using Concealed Posteroseptal Accessory Pathway by 12-Lead Electrocardiography

Supraventricular tachycardias (SVTs) comprise a group of usually benign arrhythmias that originate from cardiac tissue at or above the His bundle. SVTs include inappropriate sinus tachycardia, atrial tachycardias (ATs), atrial flutter (AFL), junctional tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT), and forms of accessory pathway–mediated reentrant tachycardias (atrioventricular reentrant tachycardia [AVRT]). Although mostly benign, symptoms can be debilitating, in the form of palpitations, shortness of breath, chest discomfort, dizziness, and/or syncope; rarely, SVTs can result in cardiomyopathy due to incessant arrhythmia. This review covers the epidemiology, diagnosis, management, and classification of SVTs. This review contains 14 figures, 17 tables, and 61 references. Keywords: Supraventricular tachycardia, cardioversion, arrhythmia, atrial flutter, atrial fibrillation, Wolff-Parkinson-White syndrome, MAZE procedure, catheter ablation

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589 Differentiating atrioventricular nodal reentrant tachycardia from atrioventricular reentrant tachycardia via concealed accessory pathway

EP Europace ◽

10.1016/eupace/7.supplement_1.132 ◽

2005 ◽

Vol 7 (Supplement_1) ◽

pp. 132-132

Author(s):

A. Arya ◽

H. Kottkamp ◽

C. Piorkowski ◽

P. Schirdewahn ◽

H. Tanner ◽

...

Keyword(s):

Accessory Pathway ◽

Atrioventricular Nodal Reentrant Tachycardia ◽

Reentrant Tachycardia ◽

Atrioventricular Reentrant Tachycardia ◽

Concealed Accessory Pathway

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Flecainide-induced incessant orthodromic atrioventricular reentrant tachycardia in Wolff-Parkinson-White syndrome: Uneven depression of accessory pathway conduction

HeartRhythm Case Reports ◽

10.1016/j.hrcr.2016.08.001 ◽

2016 ◽

Vol 2 (6) ◽

pp. 506-510 ◽

Cited By ~ 1

Author(s):

Oscar A. Pellizzón ◽

Manlio F. Márquez ◽

Mario D. González ◽

Sebastián Nannini ◽

Rodolfo Leiva ◽

...

Keyword(s):

Accessory Pathway ◽

Reentrant Tachycardia ◽

White Syndrome ◽

Atrioventricular Reentrant Tachycardia ◽

Wolff Parkinson White Syndrome

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Introduction

ESC CardioMed ◽

10.1093/med/9780198784906.003.0475 ◽

2018 ◽

pp. 2049-2050

Author(s):

Carina Blomström-Lundqvist

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Atrial Tachycardia ◽

Atrioventricular Node ◽

Supraventricular Arrhythmia ◽

Atrioventricular Nodal Reentrant Tachycardia ◽

Reentrant Tachycardia ◽

Atrioventricular Reentrant Tachycardia ◽

Dc Cardioversion ◽

Premature Beats

Supraventricular arrhythmias encompass atrial premature beats, supraventricular tachycardias (SVTs), and atrial fibrillation. SVT is used to describe tachycardias in which the mechanism involves tissue from the His bundle or above, thus including atrial tachycardias, atrioventricular nodal reentrant tachycardia, and atrioventricular reentrant tachycardia due to accessory pathways. Atrial fibrillation is not included among the SVTs and is described elsewhere. The term tachycardia refers to atrial and/or ventricular rates greater than 100 beats per minute at rest. Atrial premature beats, the most common supraventricular arrhythmia, can be seen in Holter recordings in the majority of healthy individuals, and increase in frequency with age and presence of structural heart disease. Paroxysmal SVTs that can be terminated by vagal manoeuvres are usually reentrant tachycardias involving the atrioventricular node, such as atrioventricular nodal reentrant tachycardia or atrioventricular reentrant tachycardia. Symptoms may result in a poor quality of life. Rarely, patients with the Wolff–Parkinson–White syndrome develop atrial fibrillation that may degenerate into ventricular fibrillation in case the anterograde refractory period of the accessory pathway is very short and permanent forms of SVTs result in tachycardiomyopathy with left ventricular dysfunction. Paroxysmal SVT can be terminated by vagal manoeuvres, adenosine, overdrive pacing, and DC cardioversion. Atrial flutter, the most common atrial tachycardia, is a macro-reentrant atrial tachycardia that can be terminated by drugs, overdrive atrial pacing, and DC cardioversion. Most SVTs can be successfully treated by catheter ablation facilitated by modern electroanatomical mapping systems. Long-term antiarrhythmic drug therapy may be required for patients who are not suitable for or cured by catheter ablation.

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Risk factors of recurrence and complication in radiofrequency catheter ablation of atrioventricular reentrant tachycardia in children and adolescents

Cardiology in the Young ◽

10.1017/s1047951112001655 ◽

2013 ◽

Vol 23 (5) ◽

pp. 682-691 ◽

Cited By ~ 8

Author(s):

Tien H. Chen ◽

Ming-Lung Tsai ◽

Po-Cheng Chang ◽

Hung-Ta Wo ◽

Chung-Chuan Chou ◽

...

Keyword(s):

Risk Factors ◽

Congenital Heart Disease ◽

Catheter Ablation ◽

Children And Adolescents ◽

Radiofrequency Catheter Ablation ◽

Congenital Heart ◽

Accessory Pathway ◽

Reentrant Tachycardia ◽

Atrioventricular Reentrant Tachycardia ◽

Accessory Pathways

AbstractBackgroundTo compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic atrioventricular reentrant tachycardia in children and adolescents.MethodsWe retrospectively reviewed the data of 213 consecutive patients with symptomatic atrioventricular reentrant tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age <12 years) and adolescents (12 ≤ age < 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups.ResultsThe position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children.ConclusionsThe findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of atrioventricular reentrant tachycardia in children and adolescents.

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