P-174 Detailed Electroanatomical Mapping of Slow and Intermediate Pathway in Atypical 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: Slow pathway is the target of successful ablation in a patient with atrioventricular node (AVN) reentry tachycardia (AVNRT). However, detailed mapping of the AVN electroanatomy has not been clarified in vivo. Methods: To investigate the 3-dimensional anatomy of slow or intermediate pathway of AVN extensions, we studied 4 patients (pts) of fast-slow (F/S), 2 pts of fast intermediate (F/I), and 2 pts of slow-intermediate (S/I) 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 right and the left His bundle electrograms were recorded. The earliest retrograde atrial activation sites (RAAs) were analyzed during AVNRT. Results: RAAs in F/I and S/I AVNRT were all at anterosepal area, with 2 pts (50%) at right, 1 pt (25%) at left, and simultaneous at right and left in 1 pt (25%). In F/S AVNRT,
RAAs were at right posteroseptum in 2 pts (50%), anterosepal (simultaneous right and left) in 2 pts (50%). RAA via intermediate pathway at the Koch’s triangle was usually focal (3/4 pts, 75%), while RAA via slow pathway showed more broad breakthrough (1/4 pts, 25%). Conclusion: This strategy using multiple decapolar catheters to surround AVN made the evaluation of AVN extensions possible. The left extension used as the retrograde pathway limb of atypical AVNRT was not uncommon.
Original languageEnglish
Pages (from-to)S101
JournalGlobal Heart
Volume4
DOIs
Publication statusPublished - May 1 2009
Externally publishedYes

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Atrioventricular Nodal Reentry Tachycardia
Atrioventricular Node
Tachycardia
Electrodes
Cardiac Electrophysiologic Techniques
Coronary Sinus
Tendons
Heart Ventricles
Anatomy
Catheters
Extremities

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P-174 Detailed Electroanatomical Mapping of Slow and Intermediate Pathway in Atypical 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-174 Detailed Electroanatomical Mapping of Slow and Intermediate Pathway in Atypical Atrioventricular Nodal Reentry Tachycardia. In: Global Heart. 2009 ; Vol. 4. pp. S101.
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abstract = "Background: Slow pathway is the target of successful ablation in a patient with atrioventricular node (AVN) reentry tachycardia (AVNRT). However, detailed mapping of the AVN electroanatomy has not been clarified in vivo. Methods: To investigate the 3-dimensional anatomy of slow or intermediate pathway of AVN extensions, we studied 4 patients (pts) of fast-slow (F/S), 2 pts of fast intermediate (F/I), and 2 pts of slow-intermediate (S/I) 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 right and the left His bundle electrograms were recorded. The earliest retrograde atrial activation sites (RAAs) were analyzed during AVNRT. Results: RAAs in F/I and S/I AVNRT were all at anterosepal area, with 2 pts (50{\%}) at right, 1 pt (25{\%}) at left, and simultaneous at right and left in 1 pt (25{\%}). In F/S AVNRT,RAAs were at right posteroseptum in 2 pts (50{\%}), anterosepal (simultaneous right and left) in 2 pts (50{\%}). RAA via intermediate pathway at the Koch’s triangle was usually focal (3/4 pts, 75{\%}), while RAA via slow pathway showed more broad breakthrough (1/4 pts, 25{\%}). Conclusion: This strategy using multiple decapolar catheters to surround AVN made the evaluation of AVN extensions possible. The left extension used as the retrograde pathway limb of atypical AVNRT was not uncommon.",
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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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

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N2 - Background: Slow pathway is the target of successful ablation in a patient with atrioventricular node (AVN) reentry tachycardia (AVNRT). However, detailed mapping of the AVN electroanatomy has not been clarified in vivo. Methods: To investigate the 3-dimensional anatomy of slow or intermediate pathway of AVN extensions, we studied 4 patients (pts) of fast-slow (F/S), 2 pts of fast intermediate (F/I), and 2 pts of slow-intermediate (S/I) 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 right and the left His bundle electrograms were recorded. The earliest retrograde atrial activation sites (RAAs) were analyzed during AVNRT. Results: RAAs in F/I and S/I AVNRT were all at anterosepal area, with 2 pts (50%) at right, 1 pt (25%) at left, and simultaneous at right and left in 1 pt (25%). In F/S AVNRT,RAAs were at right posteroseptum in 2 pts (50%), anterosepal (simultaneous right and left) in 2 pts (50%). RAA via intermediate pathway at the Koch’s triangle was usually focal (3/4 pts, 75%), while RAA via slow pathway showed more broad breakthrough (1/4 pts, 25%). Conclusion: This strategy using multiple decapolar catheters to surround AVN made the evaluation of AVN extensions possible. The left extension used as the retrograde pathway limb of atypical AVNRT was not uncommon.

AB - Background: Slow pathway is the target of successful ablation in a patient with atrioventricular node (AVN) reentry tachycardia (AVNRT). However, detailed mapping of the AVN electroanatomy has not been clarified in vivo. Methods: To investigate the 3-dimensional anatomy of slow or intermediate pathway of AVN extensions, we studied 4 patients (pts) of fast-slow (F/S), 2 pts of fast intermediate (F/I), and 2 pts of slow-intermediate (S/I) 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 right and the left His bundle electrograms were recorded. The earliest retrograde atrial activation sites (RAAs) were analyzed during AVNRT. Results: RAAs in F/I and S/I AVNRT were all at anterosepal area, with 2 pts (50%) at right, 1 pt (25%) at left, and simultaneous at right and left in 1 pt (25%). In F/S AVNRT,RAAs were at right posteroseptum in 2 pts (50%), anterosepal (simultaneous right and left) in 2 pts (50%). RAA via intermediate pathway at the Koch’s triangle was usually focal (3/4 pts, 75%), while RAA via slow pathway showed more broad breakthrough (1/4 pts, 25%). Conclusion: This strategy using multiple decapolar catheters to surround AVN made the evaluation of AVN extensions possible. The left extension used as the retrograde pathway limb of atypical AVNRT was not uncommon.

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