The electrophysiologic characteristics of atrioventricular nodal reentry tachycardia with eccentric retrograde activation

Mary Gertrude Y Ong, Pi Chang Lee, Ching Tai Tai, Yenn Jiang Lin, Ming Hsiung Hsieh, Yi Jen Chen, Kun Tai Lee, Hsuan Ming Tsao, Jen Yuan Kuo, Shih Lin Chang, Shih Ann Chen

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8% in patients with atrioventricular nodal reentrant tachycardia (AVNRT) by several previous reports. However, most of those reports were limited by the absence of coronary sinus venography to confirm if the retrograde activation was truly left sided. The purposes of this study were to 1) determine the incidence of left sided retrograde atrial activation in our center, 2) determine the specific electrophysiologic characteristics of eccentric and concentric atrial activation and 3) determine the outcome of radiofrequency catheter ablation for AVNRT with eccentric retrograde atrial activation. Methods: From November 2001 to July 2004, 290 consecutive patients with AVNRT who underwent an electrophysiologic study and radiofrequency ablation were included. Group 1 consisted of AVNRT patients with eccentric retrograde atrial activation; group 2 consisted of AVNRT patients with concentric retrograde atrial activation. The electrophysiologic characteristics of the group 1 and group 2 patients were then compared. Results: The incidence of AVNRT with eccentric retrograde activation confirmed by CS venography was 6.5%. There were more females and atypical AVNRT in patients with retrograde eccentric conduction. There was more VA block after ablation and tachycardia induction by right ventricular pacing/extrastimuli in eccentric rather than concentric retrograde atrial activation. A shorter antegrade fast functional refractory period of the AV node was demonstrated in the atypical eccentric group as compared to the atypical concentric group. Conclusion: This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Successful ablation sites were similar to the standard RA ablation sites in patients with retrograde eccentric conduction.

Original languageEnglish
Pages (from-to)115-122
Number of pages8
JournalInternational Journal of Cardiology
Volume120
Issue number1
DOIs
Publication statusPublished - Aug 9 2007
Externally publishedYes

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Atrioventricular Nodal Reentry Tachycardia
Phlebography
Atrioventricular Node
Catheter Ablation
Coronary Sinus
Incidence
Tachycardia

Keywords

  • Atrioventricular nodal reentrant tachycardia
  • Eccentric retrograde atrial activation
  • Electrophysiology
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The electrophysiologic characteristics of atrioventricular nodal reentry tachycardia with eccentric retrograde activation. / Ong, Mary Gertrude Y; Lee, Pi Chang; Tai, Ching Tai; Lin, Yenn Jiang; Hsieh, Ming Hsiung; Chen, Yi Jen; Lee, Kun Tai; Tsao, Hsuan Ming; Kuo, Jen Yuan; Chang, Shih Lin; Chen, Shih Ann.

In: International Journal of Cardiology, Vol. 120, No. 1, 09.08.2007, p. 115-122.

Research output: Contribution to journalArticle

Ong, Mary Gertrude Y ; Lee, Pi Chang ; Tai, Ching Tai ; Lin, Yenn Jiang ; Hsieh, Ming Hsiung ; Chen, Yi Jen ; Lee, Kun Tai ; Tsao, Hsuan Ming ; Kuo, Jen Yuan ; Chang, Shih Lin ; Chen, Shih Ann. / The electrophysiologic characteristics of atrioventricular nodal reentry tachycardia with eccentric retrograde activation. In: International Journal of Cardiology. 2007 ; Vol. 120, No. 1. pp. 115-122.
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abstract = "Background: The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8{\%} in patients with atrioventricular nodal reentrant tachycardia (AVNRT) by several previous reports. However, most of those reports were limited by the absence of coronary sinus venography to confirm if the retrograde activation was truly left sided. The purposes of this study were to 1) determine the incidence of left sided retrograde atrial activation in our center, 2) determine the specific electrophysiologic characteristics of eccentric and concentric atrial activation and 3) determine the outcome of radiofrequency catheter ablation for AVNRT with eccentric retrograde atrial activation. Methods: From November 2001 to July 2004, 290 consecutive patients with AVNRT who underwent an electrophysiologic study and radiofrequency ablation were included. Group 1 consisted of AVNRT patients with eccentric retrograde atrial activation; group 2 consisted of AVNRT patients with concentric retrograde atrial activation. The electrophysiologic characteristics of the group 1 and group 2 patients were then compared. Results: The incidence of AVNRT with eccentric retrograde activation confirmed by CS venography was 6.5{\%}. There were more females and atypical AVNRT in patients with retrograde eccentric conduction. There was more VA block after ablation and tachycardia induction by right ventricular pacing/extrastimuli in eccentric rather than concentric retrograde atrial activation. A shorter antegrade fast functional refractory period of the AV node was demonstrated in the atypical eccentric group as compared to the atypical concentric group. Conclusion: This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Successful ablation sites were similar to the standard RA ablation sites in patients with retrograde eccentric conduction.",
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T1 - The electrophysiologic characteristics of atrioventricular nodal reentry tachycardia with eccentric retrograde activation

AU - Ong, Mary Gertrude Y

AU - Lee, Pi Chang

AU - Tai, Ching Tai

AU - Lin, Yenn Jiang

AU - Hsieh, Ming Hsiung

AU - Chen, Yi Jen

AU - Lee, Kun Tai

AU - Tsao, Hsuan Ming

AU - Kuo, Jen Yuan

AU - Chang, Shih Lin

AU - Chen, Shih Ann

PY - 2007/8/9

Y1 - 2007/8/9

N2 - Background: The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8% in patients with atrioventricular nodal reentrant tachycardia (AVNRT) by several previous reports. However, most of those reports were limited by the absence of coronary sinus venography to confirm if the retrograde activation was truly left sided. The purposes of this study were to 1) determine the incidence of left sided retrograde atrial activation in our center, 2) determine the specific electrophysiologic characteristics of eccentric and concentric atrial activation and 3) determine the outcome of radiofrequency catheter ablation for AVNRT with eccentric retrograde atrial activation. Methods: From November 2001 to July 2004, 290 consecutive patients with AVNRT who underwent an electrophysiologic study and radiofrequency ablation were included. Group 1 consisted of AVNRT patients with eccentric retrograde atrial activation; group 2 consisted of AVNRT patients with concentric retrograde atrial activation. The electrophysiologic characteristics of the group 1 and group 2 patients were then compared. Results: The incidence of AVNRT with eccentric retrograde activation confirmed by CS venography was 6.5%. There were more females and atypical AVNRT in patients with retrograde eccentric conduction. There was more VA block after ablation and tachycardia induction by right ventricular pacing/extrastimuli in eccentric rather than concentric retrograde atrial activation. A shorter antegrade fast functional refractory period of the AV node was demonstrated in the atypical eccentric group as compared to the atypical concentric group. Conclusion: This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Successful ablation sites were similar to the standard RA ablation sites in patients with retrograde eccentric conduction.

AB - Background: The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8% in patients with atrioventricular nodal reentrant tachycardia (AVNRT) by several previous reports. However, most of those reports were limited by the absence of coronary sinus venography to confirm if the retrograde activation was truly left sided. The purposes of this study were to 1) determine the incidence of left sided retrograde atrial activation in our center, 2) determine the specific electrophysiologic characteristics of eccentric and concentric atrial activation and 3) determine the outcome of radiofrequency catheter ablation for AVNRT with eccentric retrograde atrial activation. Methods: From November 2001 to July 2004, 290 consecutive patients with AVNRT who underwent an electrophysiologic study and radiofrequency ablation were included. Group 1 consisted of AVNRT patients with eccentric retrograde atrial activation; group 2 consisted of AVNRT patients with concentric retrograde atrial activation. The electrophysiologic characteristics of the group 1 and group 2 patients were then compared. Results: The incidence of AVNRT with eccentric retrograde activation confirmed by CS venography was 6.5%. There were more females and atypical AVNRT in patients with retrograde eccentric conduction. There was more VA block after ablation and tachycardia induction by right ventricular pacing/extrastimuli in eccentric rather than concentric retrograde atrial activation. A shorter antegrade fast functional refractory period of the AV node was demonstrated in the atypical eccentric group as compared to the atypical concentric group. Conclusion: This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Successful ablation sites were similar to the standard RA ablation sites in patients with retrograde eccentric conduction.

KW - Atrioventricular nodal reentrant tachycardia

KW - Eccentric retrograde atrial activation

KW - Electrophysiology

KW - Radiofrequency ablation

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