scholarly journals Split Accessory Pathway Potentials in a Patient with Antidromic AVRT

2021 ◽  
Author(s):  
Weizhuo Liu ◽  
Wentao Gu ◽  
Xinping Luo ◽  
Jian Li ◽  
Nanqing Xiong
Keyword(s):  
Accessory Pathway ◽  
Conduction Delay ◽  
Tricuspid Annulus ◽  
Reentrant Tachycardia ◽  
Delta Wave ◽  
Electrophysiology Study ◽  
Isoproterenol Infusion

A 27-year-old female presenting palpitation without ECG documentation underwent electrophysiology study. EP study revealed atrioventricular accessory pathway with poor and unidirectional pathway conduction, and a fasciculoventricular pathway. During isoproterenol infusion, delta wave promptly became prominent, after which an antidromic AV reentrant tachycardia was induced. When the pathway was mapped, widely split double pathway potentials were observed at 12 o’clock site of tricuspid annulus during mild preexcitation, demonstrating an example of intra-pathway conduction delay, which can be reversed by isoproterenol. Ablation at the site caused accelerated pathway rhythm and eliminated the pathway, rendering the tachycardia non-inducible.

scholarly journals Abolishment of high-risk left lateral accessory pathway by myocardial infarction: a blessing in disguise? A case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Jim O’Brien ◽  
Nikola Kozhuharov ◽  
Shui Hao Chin ◽  
Mark Hall
Keyword(s):  
Atrial Fibrillation ◽  
Acute Coronary Syndrome ◽  
Case Report ◽  
High Risk ◽  
Coronary Sinus ◽  
Refractory Period ◽  
Accessory Pathway ◽  
Coronary Syndrome ◽  
Electrophysiology Study ◽  
Anomalous Coronary

Abstract Background Antegradely conducting left lateral accessory pathways are a risk for supraventricular tachycardias and pre-excited atrial fibrillation. Rarely, an anomalous coronary sinus can cause difficulty in locating the pathway. The left circumflex coronary artery and obtuse marginal branches supply the posterolateral left ventricle. We describe a case report of a high-risk accessory pathway associated with an anomalous coronary sinus which, between successive electrophysiology studies, was obliterated by a felicitous acute coronary syndrome in the left circumflex territory. Case summary A 49-year-old male with palpitations and manifest pre-excitation was referred for electrophysiology study. Initial study revealed a high-risk left lateral accessory pathway with antegrade effective refractory period of 240 ms and rapidly conducting pre-excited atrial fibrillation. The coronary sinus could not be cannulated to localize the pathway. Coronary angiography and cardiac computed tomography showed an anomalous coronary sinus emptying into the right atrial free wall and patent coronaries. While awaiting repeat electrophysiology study, the patient suffered an acute coronary syndrome with immediate loss of previously visible pre-excitation on electrocardiogram, and underwent stenting of an occluded marginal branch of the circumflex. Repeat electrophysiology study demonstrated a now low-risk accessory pathway (effective refractory period 390 ms). Since infarction, the patient’s palpitations have fully settled with all subsequent electrocardiograms devoid of manifest pre-excitation. Discussion Left lateral accessory pathways, which can associate with an anomalous coronary sinus, derive from tissue similar to normal ventricular myocardium and are vulnerable to ischaemic insults in the area subtended by the circumflex artery.

scholarly journals Catheter Ablation of Atrioventricular Accessory Pathway with Decremental Properties Connecting to the Tricuspid Annulus.

1994 ◽  
Vol 35 (2) ◽  
pp. 249-253
Author(s):  
Yasuteru YAMAUCHI ◽  
Akihiko NOGAMI ◽  
Masahiko GOYA ◽  
Kazutaka AONUMA ◽  
Yoshito IESAKA ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Accessory Pathway ◽  
Tricuspid Annulus

Supraventricular Tachycardia

2020 ◽  
Author(s):  
Laurence M. Epstein ◽  
Saurabh Kumar
Keyword(s):  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Tissue ◽  
Accessory Pathway ◽  
Maze Procedure ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Inappropriate Sinus Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Supraventricular Tachycardias

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

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

2013 ◽  
Vol 23 (5) ◽  
pp. 682-691 ◽  
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.

Number of Beats in the Transition Zone With Fixed SA Interval during Right Ventricular Overdrive Pacing Determines Accessory Pathway Location in Orthodromic Reentrant Tachycardia

2015 ◽  
Vol 39 (1) ◽  
pp. 21-27 ◽  
Author(s):  
FINN AKERSTRÖM ◽  
MARTA PACHÓN ◽  
FRANCISCO JAVIER GARCÍA-FERNÁNDEZ ◽  
ÓSCAR SALVADOR-MONTAÑÉS ◽  
MATS JENSEN-URSTAD ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Transition Zone ◽  
Accessory Pathway ◽  
Reentrant Tachycardia ◽  
Overdrive Pacing

scholarly journals 176-29: Number of beats in the transition zone with fixed SA interval during right ventricular overdrive pacing determines accessory pathway location in orthodromic reentrant tachycardia

EP Europace ◽  
2016 ◽  
Vol 18 (suppl_1) ◽  
pp. i124-i124
Author(s):  
Finn Akerström ◽  
Marta Pachón ◽  
Javier García-Fernández ◽  
Oscar Salvador-Montañes ◽  
Mats Jensen-Urstad ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Transition Zone ◽  
Accessory Pathway ◽  
Reentrant Tachycardia ◽  
Overdrive Pacing
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