Novel electrophysiological characteristics of atrioventricular nodal continuous conduction curves in atrioventricular nodal re-entrant tachycardia with concomitant cavotricuspid isthmus-dependent atrial flutter

Chung Hsing Lin, Yenn Jiang Lin, Shih Lin Chang, Li Wei Lo, Hung Kai Huang, Cheng Hung Chiang, Suresh Allamsetty, Jo Nan Liao, Fa Po Chung, Yao Ting Chang, Chin Yu Lin, Shih Ann Chen

Research output: Contribution to journalArticle

Abstract

Aims The detailed electrophysiological characteristics of patients with both atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial flutter (AFL) have not been clarified. This study investigated the related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation of AVNRT. Methods and results A total of 1063 clinically documented AVNRT patients underwent catheter ablation were enrolled. Before the slow pathway (SP) ablation, 61 patients (5.7%) had inducible sustained cavotricuspid isthmus (CTI)-dependent AFL (Group 1), and the others (94.3%) without inducible sustained CTI-dependent AFL were defined as Group 2. The electrophysiological characteristics of these two groups and effect of the SP ablation on the inducibility of AFL were assessed. In Group 1, 36 patients (59%) had inducible/sustained AFL after the ablation of AVNRT and required a CTI ablation. The Group 1 patients had more AVNRT with continuous atrioventricular (AV) node function curves (P < 0.001, odds ratio = 7.55 [3.70-16.7], multivariate regression), and a younger age (P = 0.02, odds ratio = 1.02 [1.003-1.03], multivariate regression) than Group 2. The other characteristics were comparable between the two groups. The long-term follow-up (64.9 ± 34.9 months) revealed that the recurrence of AFL/atrial fibrillation was similar between the two groups (P > 0.05). Conclusion Atrioventricular nodal re-entrant tachycardia patients with concomitant CTI-dependent AFL had more continuous AV node function curves. Forty-one per cent of these patients had non-inducible AFL after the SP ablation, indicating a slow conduction isthmus in the triangle of Koch area.

Original languageEnglish
Pages (from-to)1259-1264
Number of pages6
JournalEuropace
Volume18
Issue number8
DOIs
Publication statusPublished - Aug 1 2016
Externally publishedYes

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Atrial Flutter
Tachycardia
Atrioventricular Node
Catheter Ablation

Keywords

  • Ablation
  • Atrial flutter
  • Atrioventricular nodal re-entrant tachycardia
  • Cavotricuspid isthmus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Novel electrophysiological characteristics of atrioventricular nodal continuous conduction curves in atrioventricular nodal re-entrant tachycardia with concomitant cavotricuspid isthmus-dependent atrial flutter. / Lin, Chung Hsing; Lin, Yenn Jiang; Chang, Shih Lin; Lo, Li Wei; Huang, Hung Kai; Chiang, Cheng Hung; Allamsetty, Suresh; Liao, Jo Nan; Chung, Fa Po; Chang, Yao Ting; Lin, Chin Yu; Chen, Shih Ann.

In: Europace, Vol. 18, No. 8, 01.08.2016, p. 1259-1264.

Research output: Contribution to journalArticle

Lin, Chung Hsing ; Lin, Yenn Jiang ; Chang, Shih Lin ; Lo, Li Wei ; Huang, Hung Kai ; Chiang, Cheng Hung ; Allamsetty, Suresh ; Liao, Jo Nan ; Chung, Fa Po ; Chang, Yao Ting ; Lin, Chin Yu ; Chen, Shih Ann. / Novel electrophysiological characteristics of atrioventricular nodal continuous conduction curves in atrioventricular nodal re-entrant tachycardia with concomitant cavotricuspid isthmus-dependent atrial flutter. In: Europace. 2016 ; Vol. 18, No. 8. pp. 1259-1264.
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abstract = "Aims The detailed electrophysiological characteristics of patients with both atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial flutter (AFL) have not been clarified. This study investigated the related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation of AVNRT. Methods and results A total of 1063 clinically documented AVNRT patients underwent catheter ablation were enrolled. Before the slow pathway (SP) ablation, 61 patients (5.7{\%}) had inducible sustained cavotricuspid isthmus (CTI)-dependent AFL (Group 1), and the others (94.3{\%}) without inducible sustained CTI-dependent AFL were defined as Group 2. The electrophysiological characteristics of these two groups and effect of the SP ablation on the inducibility of AFL were assessed. In Group 1, 36 patients (59{\%}) had inducible/sustained AFL after the ablation of AVNRT and required a CTI ablation. The Group 1 patients had more AVNRT with continuous atrioventricular (AV) node function curves (P < 0.001, odds ratio = 7.55 [3.70-16.7], multivariate regression), and a younger age (P = 0.02, odds ratio = 1.02 [1.003-1.03], multivariate regression) than Group 2. The other characteristics were comparable between the two groups. The long-term follow-up (64.9 ± 34.9 months) revealed that the recurrence of AFL/atrial fibrillation was similar between the two groups (P > 0.05). Conclusion Atrioventricular nodal re-entrant tachycardia patients with concomitant CTI-dependent AFL had more continuous AV node function curves. Forty-one per cent of these patients had non-inducible AFL after the SP ablation, indicating a slow conduction isthmus in the triangle of Koch area.",
keywords = "Ablation, Atrial flutter, Atrioventricular nodal re-entrant tachycardia, Cavotricuspid isthmus",
author = "Lin, {Chung Hsing} and Lin, {Yenn Jiang} and Chang, {Shih Lin} and Lo, {Li Wei} and Huang, {Hung Kai} and Chiang, {Cheng Hung} and Suresh Allamsetty and Liao, {Jo Nan} and Chung, {Fa Po} and Chang, {Yao Ting} and Lin, {Chin Yu} and Chen, {Shih Ann}",
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T1 - Novel electrophysiological characteristics of atrioventricular nodal continuous conduction curves in atrioventricular nodal re-entrant tachycardia with concomitant cavotricuspid isthmus-dependent atrial flutter

AU - Lin, Chung Hsing

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Huang, Hung Kai

AU - Chiang, Cheng Hung

AU - Allamsetty, Suresh

AU - Liao, Jo Nan

AU - Chung, Fa Po

AU - Chang, Yao Ting

AU - Lin, Chin Yu

AU - Chen, Shih Ann

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Aims The detailed electrophysiological characteristics of patients with both atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial flutter (AFL) have not been clarified. This study investigated the related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation of AVNRT. Methods and results A total of 1063 clinically documented AVNRT patients underwent catheter ablation were enrolled. Before the slow pathway (SP) ablation, 61 patients (5.7%) had inducible sustained cavotricuspid isthmus (CTI)-dependent AFL (Group 1), and the others (94.3%) without inducible sustained CTI-dependent AFL were defined as Group 2. The electrophysiological characteristics of these two groups and effect of the SP ablation on the inducibility of AFL were assessed. In Group 1, 36 patients (59%) had inducible/sustained AFL after the ablation of AVNRT and required a CTI ablation. The Group 1 patients had more AVNRT with continuous atrioventricular (AV) node function curves (P < 0.001, odds ratio = 7.55 [3.70-16.7], multivariate regression), and a younger age (P = 0.02, odds ratio = 1.02 [1.003-1.03], multivariate regression) than Group 2. The other characteristics were comparable between the two groups. The long-term follow-up (64.9 ± 34.9 months) revealed that the recurrence of AFL/atrial fibrillation was similar between the two groups (P > 0.05). Conclusion Atrioventricular nodal re-entrant tachycardia patients with concomitant CTI-dependent AFL had more continuous AV node function curves. Forty-one per cent of these patients had non-inducible AFL after the SP ablation, indicating a slow conduction isthmus in the triangle of Koch area.

AB - Aims The detailed electrophysiological characteristics of patients with both atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial flutter (AFL) have not been clarified. This study investigated the related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation of AVNRT. Methods and results A total of 1063 clinically documented AVNRT patients underwent catheter ablation were enrolled. Before the slow pathway (SP) ablation, 61 patients (5.7%) had inducible sustained cavotricuspid isthmus (CTI)-dependent AFL (Group 1), and the others (94.3%) without inducible sustained CTI-dependent AFL were defined as Group 2. The electrophysiological characteristics of these two groups and effect of the SP ablation on the inducibility of AFL were assessed. In Group 1, 36 patients (59%) had inducible/sustained AFL after the ablation of AVNRT and required a CTI ablation. The Group 1 patients had more AVNRT with continuous atrioventricular (AV) node function curves (P < 0.001, odds ratio = 7.55 [3.70-16.7], multivariate regression), and a younger age (P = 0.02, odds ratio = 1.02 [1.003-1.03], multivariate regression) than Group 2. The other characteristics were comparable between the two groups. The long-term follow-up (64.9 ± 34.9 months) revealed that the recurrence of AFL/atrial fibrillation was similar between the two groups (P > 0.05). Conclusion Atrioventricular nodal re-entrant tachycardia patients with concomitant CTI-dependent AFL had more continuous AV node function curves. Forty-one per cent of these patients had non-inducible AFL after the SP ablation, indicating a slow conduction isthmus in the triangle of Koch area.

KW - Ablation

KW - Atrial flutter

KW - Atrioventricular nodal re-entrant tachycardia

KW - Cavotricuspid isthmus

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