scholarly journals Ventriculatrial Block During Atrioventricular Nodal Reentrant Tachycardia Suggesting Existence of an Upper Common Pathway

2005 ◽  
Vol 46 (2) ◽  
pp. 333-338 ◽  
Author(s):  
Sedat Kose ◽  
Basri Amasyali ◽  
Kudret Aytemir ◽  
Ayhan Kilic ◽  
Atila Iyisoy ◽  
...  
Keyword(s):  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway

Atrioventricular nodal reentrant tachycardia with lower common pathway Wenckebach block

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S326
Author(s):  
Nitish Badhwar ◽  
Randall J. Lee ◽  
Zian H. Tseng ◽  
Byron K. Lee ◽  
Melvin M. Scheinman ◽  
...  
Keyword(s):  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway ◽  
Wenckebach Block

Analysis of Atrioventricular Nodal Reentrant Tachycardia with Variable Ventriculoatrial Block: Characteristics of the Upper Common Pathway

2009 ◽  
Vol 32 (4) ◽  
pp. 484-493 ◽  
Author(s):  
KENJI MORIHISA ◽  
HIROSHIGE YAMABE ◽  
TAKASHI UEMURA ◽  
YASUAKI TANAKA ◽  
KOJI ENOMOTO ◽  
...  
Keyword(s):  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway

scholarly journals Lower common pathway location detected by cryoablation of atrioventricular nodal reentrant tachycardia of the common variety

2019 ◽  
Vol 7 (11) ◽  
pp. 2202-2206
Author(s):  
Kaoru Okishige ◽  
Takatoshi Shigeta ◽  
Rena A. Nakamura ◽  
Tatsuhiko Hirao ◽  
Hiroshi Yoshida ◽  
...  
Keyword(s):  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway ◽  
Common Variety ◽  
The Common

scholarly journals Classification, Electrophysiological Features and Therapy of Atrioventricular Nodal Reentrant Tachycardia

2016 ◽  
Vol 5 (2) ◽  
pp. 130 ◽  
Author(s):  
Demosthenes G Katritsis ◽  
Mark E Josephson ◽  
◽  
Keyword(s):  
Practical Significance ◽  
Slow Pathway ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway ◽  
Activation Patterns ◽  
Atrial Activation ◽  
Diagnostic Criterion ◽  
Fast Pathway

Atrioventricular nodal reentrant tachycardia (AVNRT) should be classified as typical or atypical. The term ‘fast-slow AVNRT’ is rather misleading. Retrograde atrial activation during tachycardia should not be relied upon as a diagnostic criterion. Both typical and atypical atrioventricular nodal reentrant tachycardia are compatible with varying retrograde atrial activation patterns. Attempts at establishing the presence of a ‘lower common pathway’ are probably of no practical significance. When the diagnosis of AVNRT is established, ablation should be only directed towards the anatomic position of the slow pathway. If right septal attempts are unsuccessful, the left septal side should be tried. Ablation targeting earliest atrial activation sites during typical atrioventricular nodal reentrant tachycardia or the fast pathway in general for any kind of typical or atypical atrioventricular nodal reentrant tachycardia, are not justified. In this review we discuss current concepts about the tachycardia circuit, electrophysiologic diagnosis, and ablation of this arrhythmia.

scholarly journals Superior-Type Fast-Slow Atrioventricular Nodal Reentrant Tachycardia Phenotype Mimicking the Slow-Fast Type

2020 ◽  
Vol 13 (11) ◽  
Author(s):  
Yoshiaki Kaneko ◽  
Tadashi Nakajima ◽  
Shuntaro Tamura ◽  
Hiroshi Hasegawa ◽  
Takashi Kobari ◽  
...  
Keyword(s):  
Cycle Length ◽  
Slow Pathway ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway ◽  
His Bundle ◽  
Overdrive Pacing ◽  
Atrial Activation ◽  
The Right ◽  
Superior Type

Background: Superior-type fast-slow (sup-F/S-) atrioventricular nodal reentrant tachycardia (AVNRT) is a rare AVNRT variant using a superior slow pathway (SP) as the retrograde limb. Its intracardiac appearance, characterized by a short atrio-His (AH) interval and the earliest site of atrial activation in the His-bundle, is an initial indicator for making a diagnosis. Methods: Among 22 consecutive patients with sup-F/S-AVNRT, 3 (age, 68–81 years) patients had an apparent slow-fast (S/F-) AVNRT characterized by a long AH interval and the earliest site of atrial activation in or superior to the His-bundle region (tachy-long-AH). Results: The diagnosis of sup-F/S-AVNRT was based on the standard criteria in 2 patients and on the occurrence of Wenckebach-type atrioventricular block during tachycardia, which was attributable to a block at the lower common pathway (LCP) below the circuit of the AVNRT, detected owing to the lower common pathway potentials, in one patient. As with the typical S/F-AVNRT, tachy-long-AH was induced after a jump in the AH interval. In contrast to typical S/F-AVNRT, fluctuation in the ventriculoatrial interval was observed during the tachy-long-AH. Ventricular overdrive pacing was unable to entrain or terminate the tachy-long-AH. Moreover, the tachy-long-AH reciprocally transited to/from sup-F/S-AVNRT spontaneously or was triggered by ventricular contractions while the atrial cycle length and earliest site of atrial activation remained unchanged. Both tachycardias were cured by ablation at a single site in the right-side para-Hisian region of 2 patients and the noncoronary aortic cusp of one patient. Collectively, the essential circuit of both tachycardias was identical, and the tachy-long-AH was diagnosed as another phenotype of sup-F/S-AVNRT accompanied by sustained antegrade conduction via another bystander slow pathway breaking through the His-bundle owing to the repetitive antegrade block at the lower common pathway, thus representing a long AH interval during the ongoing sup-F/S-AVNRT. Conclusions: An unknown sup-F/S-AVNRT phenotype exists that apparently mimics the typical S/F-AVNRT and is also an unknown subtype of apparent S/F-AVNRT.

Abstract 2647: Analysis of the Anatomical and Electrophysiological Characteristics of Tachycardia Circuit in Atrioventricular Nodal Reentrant Tachycardia Accompanied by the Block in the Upper Common Pathway

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kenji Morihisa ◽  
Hiroshige Yamabe ◽  
Yasuaki Tanaka ◽  
Takashi Uemura ◽  
Hisao Ogawa
Keyword(s):  
Cycle Length ◽  
Slow Pathway ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Common Pathway ◽  
Coronary Sinus Ostium ◽  
Coupling Interval ◽  
Atrial Electrogram ◽  
Sinus Ostium ◽  
Fast Pathway

We examined the anatomical and electrophysiological characteristic of the atrioventricular nodal reentrant tachycardia (AVNRT) accompanied by the ventriculo-atrial block during tachycardia, suggesting the presence of upper common pathway in 8 patients. Tachycardia was induced by the atrial burst and/or extrastimulation followed by the AH jump and the earliest atrial electrogram was observed at the His bundle (HB) site in all patients. The HA block was observed after gradual prolongation of the HA interval in 2 patient and abruptly in 6 patients. After administration of isoproterenol, 1:1 HA conduction was resumed in all patients. The tachycardia cycle length, AeHe interval and HeAe interval were 357±89, 275±55 and 80±44 msec, respectively. Single extrastimulus delivered from the HB site reset the tachycardia as soon as it was delivered during late diastole. However, single extrastimulus delivered from the inferior portion of the coronary sinus ostium (I-CSOS) was unable to reset the tachycardia without capturing the earliest atrial electrogram at the HB site, suggesting that atrium is not involved in the circuit. Thus, the longest coupling interval of single extrastimulus that reset the tachycardia at the HB site was significantly longer than that at I-CSOS (347±89 msec vs. 324±109 msec, p=0.012). The following return cycle after extrastimulation at the HB site did not differ from the tachycardia cycle length (357±89 msec, vs. 357±89 msec, p=NS), however, that at I-CSOS was significantly longer than the tachycardia cycle length (398±85 msec, vs. 357±89 msec, p=0.012). Catheter ablation was performed in a stepwise fashion starting at the inferior CSOS. Although the results of single extrastimulation showed that the atrial myocardium at I-CSOS was out of the reentry circuit, ablation near the I-CSOS, distant from HB site, selectively eliminated slow pathway conduction in all patients without impairment of fast pathway conduction. Conclusions: The AVNRT with upper common pathway has the characteristic of relatively long HA interval during tachycardia. Sub-atrial tissue, but not the atrium, extending from the HB site to I-CSOS forms the upper common pathway in AVNRT. It was shown that upper common pathway has an anatomical structure of a certain range.

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