Miniseries 2-Septal and paraseptal accessory pathways-Part III : Mid-paraseptal accessory pathways-revisiting bypass tracts crossing the pyramidal space
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissionsoup.com..
The mid-paraseptal region corresponds to the portion of the pyramidal space whose right atrial aspect is known as the triangle of Koch. The superior area of this mid-paraseptal region is also para-Hisian, and is close to the compact atrioventricular node and the His bundle. The inferior sector of the mid-paraseptal area is unrelated to the normal atrioventricular conduction pathways. It is, therefore, a safe zone in which, if necessary, to perform catheter ablation. The middle part of the mid-paraseptal zone may, however, in some patients, house components of the compact atrioventricular node. This suggests the need for adopting a prudent attitude when considering catheter ablation in this area. The inferior extensions of the atrioventricular node, which may represent the substrate for the slow atrioventricular nodal pathway, take their course through the middle, and even the inferior, sectors of the mid-paraseptal region. In this review, we contend that the middle and inferior areas of the mid-paraseptal region correspond to what, in the past, was labelled by most groups as the 'midseptal' zone. We describe the electrocardiographic patterns observed during pre-excitation and orthodromic reciprocating tachycardia in patients with pathways ablated in the middle or inferior sectors of the region. We discuss the modification of the ventriculo-atrial conduction times during tachycardia after the development of bundle branch block aberrancy. We conclude that the so-called 'intermediate septal' pathways, as described in the era of surgical ablation, were insufficiently characterized. They should not be considered the surrogate of the 'midseptal' pathways defined using endocardial catheter electrode mapping.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:24 |
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| Enthalten in: |
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology - 24(2022), 4 vom: 05. Apr., Seite 662-675 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Farré, Jerónimo [VerfasserIn] |
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| Links: |
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| Themen: |
Accessory pathway |
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| Anmerkungen: |
Date Completed 07.04.2022 Date Revised 26.05.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/europace/euab294 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM335350631 |
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| 100 | 1 | |a Farré, Jerónimo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Miniseries 2-Septal and paraseptal accessory pathways-Part III |b Mid-paraseptal accessory pathways-revisiting bypass tracts crossing the pyramidal space |
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| 500 | |a Date Revised 26.05.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: journals.permissionsoup.com. | ||
| 520 | |a The mid-paraseptal region corresponds to the portion of the pyramidal space whose right atrial aspect is known as the triangle of Koch. The superior area of this mid-paraseptal region is also para-Hisian, and is close to the compact atrioventricular node and the His bundle. The inferior sector of the mid-paraseptal area is unrelated to the normal atrioventricular conduction pathways. It is, therefore, a safe zone in which, if necessary, to perform catheter ablation. The middle part of the mid-paraseptal zone may, however, in some patients, house components of the compact atrioventricular node. This suggests the need for adopting a prudent attitude when considering catheter ablation in this area. The inferior extensions of the atrioventricular node, which may represent the substrate for the slow atrioventricular nodal pathway, take their course through the middle, and even the inferior, sectors of the mid-paraseptal region. In this review, we contend that the middle and inferior areas of the mid-paraseptal region correspond to what, in the past, was labelled by most groups as the 'midseptal' zone. We describe the electrocardiographic patterns observed during pre-excitation and orthodromic reciprocating tachycardia in patients with pathways ablated in the middle or inferior sectors of the region. We discuss the modification of the ventriculo-atrial conduction times during tachycardia after the development of bundle branch block aberrancy. We conclude that the so-called 'intermediate septal' pathways, as described in the era of surgical ablation, were insufficiently characterized. They should not be considered the surrogate of the 'midseptal' pathways defined using endocardial catheter electrode mapping | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Accessory pathway | |
| 650 | 4 | |a Electrocardiogram | |
| 650 | 4 | |a Intermediate septal pathway | |
| 650 | 4 | |a Mid-paraseptal pathway | |
| 650 | 4 | |a Midseptal pathway | |
| 650 | 4 | |a Para-Hisian pathway | |
| 650 | 4 | |a Pre-excitation | |
| 650 | 4 | |a Pyramidal space | |
| 650 | 4 | |a Triangle of Koch | |
| 700 | 1 | |a Anderson, Robert H |e verfasserin |4 aut | |
| 700 | 1 | |a Rubio, José-Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a García-Talavera, Camila |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez-Quintana, Damián |e verfasserin |4 aut | |
| 700 | 1 | |a Bansal, Raghav |e verfasserin |4 aut | |
| 700 | 1 | |a Lokhandwala, Yash |e verfasserin |4 aut | |
| 700 | 1 | |a Cabrera, José-Angel |e verfasserin |4 aut | |
| 700 | 1 | |a Wellens, Hein J J |e verfasserin |4 aut | |
| 700 | 1 | |a Back Sternick, Eduardo |e verfasserin |4 aut | |
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