Systematic observation-based diagnosis of atrioventricular nodal reentrant tachycardia with a bystander concealed nodoventricular pathway
© 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society..
Background: This study aimed to establish a systematic method for diagnosing atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander concealed nodoventricular pathway (cNVP).
Methods: We analyzed 13 cases of AVNRT with a bystander cNVP, 11 connected to the slow pathway (cNVP-SP) and two to the fast pathway (cNVP-FP), along with two cases of cNVP-related orthodromic reciprocating tachycardia (ORT).
Results: The diagnostic process was summarized in three steps. Step 1 was identification of the presence of an accessory pathway by resetting the tachycardia with delay (n = 9) and termination without atrial capture (n = 4) immediately after delivery of a His-refractory premature ventricular contraction (PVC). Step 2 was exclusion of ORT by atrio-His block during the tachycardia (n = 4), disappearance of the reset phenomenon after the early PVC (n = 7), or dissociation of His from the tachycardia during ventricular overdrive pacing (n = 1). Moreover, tachycardia reset/termination without the atrial capture (n = 2/2) 1 cycle after the His-refractory PVC was specifically diagnostic. Exceptionally, the disappearance of the reset phenomenon was also observed in the two cNVP-ORTs. Step 3 was verification of the AVN as the cNVP insertion site, evidenced by an atrial reset/block preceding the His reset/block in fast-slow AVNRT with a cNVP-SP and slow-fast AVNRT with a cNVP-FP or His reset preceding the atrial reset in slow-fast AVNRT with a cNVP-SP.
Conclusion: AVNRT with a bystander cNVP can be diagnosed in the three steps with few exceptions. Notably, tachycardia reset/termination without atrial capture one cycle after delivery of a His-refractory PVC is specifically diagnostic.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
Journal of arrhythmia - 40(2024), 1 vom: 13. Feb., Seite 131-142 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Nagashima, Koichi [VerfasserIn] |
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| Links: |
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| Themen: |
Atrioventricular nodal reentrant tachycardia |
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| Anmerkungen: |
Date Revised 10.02.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1002/joa3.12976 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368228932 |
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| 100 | 1 | |a Nagashima, Koichi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Systematic observation-based diagnosis of atrioventricular nodal reentrant tachycardia with a bystander concealed nodoventricular pathway |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Revised 10.02.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2023 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. | ||
| 520 | |a Background: This study aimed to establish a systematic method for diagnosing atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander concealed nodoventricular pathway (cNVP) | ||
| 520 | |a Methods: We analyzed 13 cases of AVNRT with a bystander cNVP, 11 connected to the slow pathway (cNVP-SP) and two to the fast pathway (cNVP-FP), along with two cases of cNVP-related orthodromic reciprocating tachycardia (ORT) | ||
| 520 | |a Results: The diagnostic process was summarized in three steps. Step 1 was identification of the presence of an accessory pathway by resetting the tachycardia with delay (n = 9) and termination without atrial capture (n = 4) immediately after delivery of a His-refractory premature ventricular contraction (PVC). Step 2 was exclusion of ORT by atrio-His block during the tachycardia (n = 4), disappearance of the reset phenomenon after the early PVC (n = 7), or dissociation of His from the tachycardia during ventricular overdrive pacing (n = 1). Moreover, tachycardia reset/termination without the atrial capture (n = 2/2) 1 cycle after the His-refractory PVC was specifically diagnostic. Exceptionally, the disappearance of the reset phenomenon was also observed in the two cNVP-ORTs. Step 3 was verification of the AVN as the cNVP insertion site, evidenced by an atrial reset/block preceding the His reset/block in fast-slow AVNRT with a cNVP-SP and slow-fast AVNRT with a cNVP-FP or His reset preceding the atrial reset in slow-fast AVNRT with a cNVP-SP | ||
| 520 | |a Conclusion: AVNRT with a bystander cNVP can be diagnosed in the three steps with few exceptions. Notably, tachycardia reset/termination without atrial capture one cycle after delivery of a His-refractory PVC is specifically diagnostic | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a atrioventricular nodal reentrant tachycardia | |
| 650 | 4 | |a nodoventricular pathway | |
| 700 | 1 | |a Maruyama, Mitsunori |e verfasserin |4 aut | |
| 700 | 1 | |a Kaneko, Yoshiaki |e verfasserin |4 aut | |
| 700 | 1 | |a Sakai, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Sekihara, Takayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Kawaji, Tetsuma |e verfasserin |4 aut | |
| 700 | 1 | |a Iwakawa, Hidehiro |e verfasserin |4 aut | |
| 700 | 1 | |a Egami, Yasuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Ota, Chisato |e verfasserin |4 aut | |
| 700 | 1 | |a Nagase, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Yagi, Tetsuo |e verfasserin |4 aut | |
| 700 | 1 | |a Suzuki, Keisuke |e verfasserin |4 aut | |
| 700 | 1 | |a Fukaya, Hidehira |e verfasserin |4 aut | |
| 700 | 1 | |a Nakamura, Hironori |e verfasserin |4 aut | |
| 700 | 1 | |a Mori, Hitoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Ueda, Akiko |e verfasserin |4 aut | |
| 700 | 1 | |a Soejima, Kyoko |e verfasserin |4 aut | |
| 700 | 1 | |a Watanabe, Ryuta |e verfasserin |4 aut | |
| 700 | 1 | |a Wakamatsu, Yuji |e verfasserin |4 aut | |
| 700 | 1 | |a Hirata, Shu |e verfasserin |4 aut | |
| 700 | 1 | |a Hirata, Moyuru |e verfasserin |4 aut | |
| 700 | 1 | |a Okumura, Yasuo |e verfasserin |4 aut | |
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