Electroanatomically estimated length of slow pathway in atrioventricular nodal reentrant tachycardiaReportar como inadecuado




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Heart and Vessels

, Volume 29, Issue 6, pp 817–824

First Online: 13 October 2013Received: 21 April 2013Accepted: 27 September 2013

Abstract

The length of the slow pathway SP-L in atrioventricular AV nodal reentrant tachycardia NRT has never been measured clinically. We studied the relationship among a SP-L, i.e., the distance between the most proximal His bundle H recording and the most posterior site of radiofrequency RF delivery associated with a junctional rhythm, b the length of Koch’s triangle Koch-L, c the conduction time over the slow pathway SP-T, measured by the AH interval during AVNRT at baseline, and d the distance between H and the site of successful ablation SucABL-L in 26 women and 20 men mean age 64.6 ± 11.6 years, using a stepwise approach and an electroanatomic mapping system EAMS. SP-L 15.0 ± 5.8 mm was correlated with Koch-L 18.6 ± 5.6 mm; R = 0.1665, P < 0.005, SP-T 415 ± 100 ms; R = 0.3425, P = 0.036, and SucABL-L 11.6 ± 4.7 mm; R = 0.5243, P < 0.0001. The site of successful ablation was located within 10 mm of the posterior end of the SP in 38 patients 82.6 %. EAMS-guided RF ablation, using a stepwise approach, revealed individual variations in SP-L related to the size of Koch’s triangle and AH interval during AVNRT. Since the site of successful ablation was also correlated with SP-L and was usually located near the posterior end of the SP, ablating anteriorly, away from the posterior end, is not a prerequisite for the success of ablation procedures.

KeywordsAtrioventricular nodal reentrant tachycardia Slow pathway Koch’s triangle Atrioventricular node Radiofrequency ablation Electroanatomic mapping  Download fulltext PDF



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