P-173 Unexpected High Prevalence of Left Nodal Extension Breakthrough in Patients with Slow fast Atrioventricular Nodal Reentry Tachycardia

Chih-Chieh Yu, Bui The Dung, Liang-Yu Lin, Fu-Chun Chiu, Chia-Ti Tsai, Ling-Ping Lai, Jiunn-Lee Lin

Research output: Contribution to journalArticle

Abstract

Background: Dual pathways inside atrioventricular node (AVN) have been postulated as the critical component of the circuit of AVN re-entry tachycardia (AVNRT). However, detailed electroanatomical mapping is lacking so far.
Methods: To investigate the 3-dimensional circuit incorporating both right and left AVN extensions, we studied 17 pts of slow-fast AVNRT by a duodecapolar electrode positioned along the tendon of Todaro, a decapolar electrode placed
along the high septum of left ventricle, and a decapolar one in the coronary sinus. The fast pathway of AVN was recorded as the earliest retrograde atrial activation site (RAA) during right ventricular pacing (RVP) and slow-fast
AVNRT. Ventricular extrastimuli were recruited during AVNRT to demonstrate the atrial activation sequence. Results: The RAAs in AVNRT were at right septum in 6 pts (35.3%), left in 4 (23.5%), simultaneous in 7 (41.2%). In the 13 patients whose RAAs involved right septum, the RAA was mainly at anteroseptal area in 10 pts (77%), less at middle and posterior septum (2 pts, 15%), and one patient
showed broad breakthrough. During RVP at comparable cycle length, RAA was at right septum in 7 pts (41.2%), left in 3 (17.6%), simultaneous in 7 (41.2%). The RAAs were concordant between AVNRT and RVP in most of the pts
(15 pts, 88.2%). Conclusion: This electroanatomical mapping study showed
unexpected high prevalence of left nodal extensionn breakthrough and the pattern of retrograde fast pathway atrial breakthrough could be variable in each patient.
Original languageTraditional Chinese
Pages (from-to)S101
JournalGlobal Heart
Volume4
DOIs
Publication statusPublished - May 1 2009
Externally publishedYes

Cite this

P-173 Unexpected High Prevalence of Left Nodal Extension Breakthrough in Patients with Slow fast Atrioventricular Nodal Reentry Tachycardia. / Yu, Chih-Chieh; Dung, Bui The; Lin, Liang-Yu; Chiu, Fu-Chun; Tsai, Chia-Ti; Lai, Ling-Ping; Lin, Jiunn-Lee.

In: Global Heart, Vol. 4, 01.05.2009, p. S101.

Research output: Contribution to journalArticle

Yu, Chih-Chieh ; Dung, Bui The ; Lin, Liang-Yu ; Chiu, Fu-Chun ; Tsai, Chia-Ti ; Lai, Ling-Ping ; Lin, Jiunn-Lee. / P-173 Unexpected High Prevalence of Left Nodal Extension Breakthrough in Patients with Slow fast Atrioventricular Nodal Reentry Tachycardia. In: Global Heart. 2009 ; Vol. 4. pp. S101.
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title = "P-173 Unexpected High Prevalence of Left Nodal Extension Breakthrough in Patients with Slow fast Atrioventricular Nodal Reentry Tachycardia",
abstract = "Background: Dual pathways inside atrioventricular node (AVN) have been postulated as the critical component of the circuit of AVN re-entry tachycardia (AVNRT). However, detailed electroanatomical mapping is lacking so far.Methods: To investigate the 3-dimensional circuit incorporating both right and left AVN extensions, we studied 17 pts of slow-fast AVNRT by a duodecapolar electrode positioned along the tendon of Todaro, a decapolar electrode placedalong the high septum of left ventricle, and a decapolar one in the coronary sinus. The fast pathway of AVN was recorded as the earliest retrograde atrial activation site (RAA) during right ventricular pacing (RVP) and slow-fastAVNRT. Ventricular extrastimuli were recruited during AVNRT to demonstrate the atrial activation sequence. Results: The RAAs in AVNRT were at right septum in 6 pts (35.3{\%}), left in 4 (23.5{\%}), simultaneous in 7 (41.2{\%}). In the 13 patients whose RAAs involved right septum, the RAA was mainly at anteroseptal area in 10 pts (77{\%}), less at middle and posterior septum (2 pts, 15{\%}), and one patientshowed broad breakthrough. During RVP at comparable cycle length, RAA was at right septum in 7 pts (41.2{\%}), left in 3 (17.6{\%}), simultaneous in 7 (41.2{\%}). The RAAs were concordant between AVNRT and RVP in most of the pts(15 pts, 88.2{\%}). Conclusion: This electroanatomical mapping study showedunexpected high prevalence of left nodal extensionn breakthrough and the pattern of retrograde fast pathway atrial breakthrough could be variable in each patient.",
author = "Chih-Chieh Yu and Dung, {Bui The} and Liang-Yu Lin and Fu-Chun Chiu and Chia-Ti Tsai and Ling-Ping Lai and Jiunn-Lee Lin",
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T1 - P-173 Unexpected High Prevalence of Left Nodal Extension Breakthrough in Patients with Slow fast Atrioventricular Nodal Reentry Tachycardia

AU - Yu, Chih-Chieh

AU - Dung, Bui The

AU - Lin, Liang-Yu

AU - Chiu, Fu-Chun

AU - Tsai, Chia-Ti

AU - Lai, Ling-Ping

AU - Lin, Jiunn-Lee

N1 - doi: 10.1016/S1875-4570(09)60365-X

PY - 2009/5/1

Y1 - 2009/5/1

N2 - Background: Dual pathways inside atrioventricular node (AVN) have been postulated as the critical component of the circuit of AVN re-entry tachycardia (AVNRT). However, detailed electroanatomical mapping is lacking so far.Methods: To investigate the 3-dimensional circuit incorporating both right and left AVN extensions, we studied 17 pts of slow-fast AVNRT by a duodecapolar electrode positioned along the tendon of Todaro, a decapolar electrode placedalong the high septum of left ventricle, and a decapolar one in the coronary sinus. The fast pathway of AVN was recorded as the earliest retrograde atrial activation site (RAA) during right ventricular pacing (RVP) and slow-fastAVNRT. Ventricular extrastimuli were recruited during AVNRT to demonstrate the atrial activation sequence. Results: The RAAs in AVNRT were at right septum in 6 pts (35.3%), left in 4 (23.5%), simultaneous in 7 (41.2%). In the 13 patients whose RAAs involved right septum, the RAA was mainly at anteroseptal area in 10 pts (77%), less at middle and posterior septum (2 pts, 15%), and one patientshowed broad breakthrough. During RVP at comparable cycle length, RAA was at right septum in 7 pts (41.2%), left in 3 (17.6%), simultaneous in 7 (41.2%). The RAAs were concordant between AVNRT and RVP in most of the pts(15 pts, 88.2%). Conclusion: This electroanatomical mapping study showedunexpected high prevalence of left nodal extensionn breakthrough and the pattern of retrograde fast pathway atrial breakthrough could be variable in each patient.

AB - Background: Dual pathways inside atrioventricular node (AVN) have been postulated as the critical component of the circuit of AVN re-entry tachycardia (AVNRT). However, detailed electroanatomical mapping is lacking so far.Methods: To investigate the 3-dimensional circuit incorporating both right and left AVN extensions, we studied 17 pts of slow-fast AVNRT by a duodecapolar electrode positioned along the tendon of Todaro, a decapolar electrode placedalong the high septum of left ventricle, and a decapolar one in the coronary sinus. The fast pathway of AVN was recorded as the earliest retrograde atrial activation site (RAA) during right ventricular pacing (RVP) and slow-fastAVNRT. Ventricular extrastimuli were recruited during AVNRT to demonstrate the atrial activation sequence. Results: The RAAs in AVNRT were at right septum in 6 pts (35.3%), left in 4 (23.5%), simultaneous in 7 (41.2%). In the 13 patients whose RAAs involved right septum, the RAA was mainly at anteroseptal area in 10 pts (77%), less at middle and posterior septum (2 pts, 15%), and one patientshowed broad breakthrough. During RVP at comparable cycle length, RAA was at right septum in 7 pts (41.2%), left in 3 (17.6%), simultaneous in 7 (41.2%). The RAAs were concordant between AVNRT and RVP in most of the pts(15 pts, 88.2%). Conclusion: This electroanatomical mapping study showedunexpected high prevalence of left nodal extensionn breakthrough and the pattern of retrograde fast pathway atrial breakthrough could be variable in each patient.

U2 - 10.1016/S1875-4570(09)60365-X

DO - 10.1016/S1875-4570(09)60365-X

M3 - 文章

VL - 4

SP - S101

JO - Global Heart

JF - Global Heart

SN - 2211-8160

ER -