Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
Identifieur interne : 000277 ( France/Analysis ); précédent : 000276; suivant : 000278Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
Auteurs : Michel Haïssaguerre [France] ; Julio Campos [Portugal] ; Frank I. Marcus [États-Unis] ; Gérard Papouin [France] ; Jacques Clémenty [France]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1994-10.
English descriptors
Abstract
Nodofascicular Connection in SVT. We present the case of a patient with episodes of supraventricular tachycardia and atrial dissociation that were terminated by either adenosine or verapamil. Involvement of an accessory pathway was shown by ventricular extrastimuli, elicited during His‐bundle refractoriness, that interrupted the tachycardia or advanced the next His potential. The tachycardia circuit was demonstrated to he confined to the nodofascicular region based on the exclusion of surrounding tissues. Atrial activity, including that in the perinodal region, was totally dissociated during tachycardia. The lowest part of the circuit was determined to be located above the Hisian bifurcation, as multiple episodes with either a right or left bundle branch configuration during tachycardia did not modify the HH cycle. The ventricular septum summit was determined not to be involved, as no preexcitation was present during tachycardia or atrial pacing, and the right bundle branch was not part of the circuit. Radiofrequency current applied beneath the tricuspid valve at the His region successfully eliminated the nodofascicular connection with preservation of 1:1 AV conduction. The anatomical substrate underlying the abnormal connection may be either nodofasciculoventricular Mahaim fibers or a duality or dispersion of the nodo‐Hisian conducting system.
Url:
DOI: 10.1111/j.1540-8167.1994.tb01124.x
Affiliations:
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Marcus</name></author><author><name sortKey="Papouin, Gerard" sort="Papouin, Gerard" uniqKey="Papouin G" first="Gérard" last="Papouin">Gérard Papouin</name></author><author><name sortKey="Clementy, Jacques" sort="Clementy, Jacques" uniqKey="Clementy J" first="Jacques" last="Clémenty">Jacques Clémenty</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:BE01CB68866CC8373CC6C86CFE26A660E20FBA48</idno><date when="1994" year="1994">1994</date><idno type="doi">10.1111/j.1540-8167.1994.tb01124.x</idno><idno type="url">https://api.istex.fr/document/BE01CB68866CC8373CC6C86CFE26A660E20FBA48/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002726</idno><idno type="wicri:Area/Main/Curation">002385</idno><idno type="wicri:Area/Main/Exploration">002429</idno><idno type="wicri:Area/France/Extraction">000277</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation</title><author><name sortKey="Haissaguerre, Michel" sort="Haissaguerre, Michel" uniqKey="Haissaguerre M" first="Michel" last="Haïssaguerre">Michel Haïssaguerre</name><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Centre Hospitalier et Universitaire dc Bordeaux. 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Hôpital Cardiologique du Hant‐Lévéque, Bordeaux‐Pessac</wicri:regionArea><wicri:noRegion>Bordeaux‐Pessac</wicri:noRegion><wicri:noRegion>Bordeaux‐Pessac</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1994-10">1994-10</date><biblScope unit="volume">5</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="854">854</biblScope><biblScope unit="page" to="862">862</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">BE01CB68866CC8373CC6C86CFE26A660E20FBA48</idno><idno type="DOI">10.1111/j.1540-8167.1994.tb01124.x</idno><idno type="ArticleID">JCE854</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>His bundle</term><term>Mahaim fibers</term><term>accessory pathway</term><term>supraventricutar tachycardia</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Nodofascicular Connection in SVT. We present the case of a patient with episodes of supraventricular tachycardia and atrial dissociation that were terminated by either adenosine or verapamil. Involvement of an accessory pathway was shown by ventricular extrastimuli, elicited during His‐bundle refractoriness, that interrupted the tachycardia or advanced the next His potential. The tachycardia circuit was demonstrated to he confined to the nodofascicular region based on the exclusion of surrounding tissues. Atrial activity, including that in the perinodal region, was totally dissociated during tachycardia. The lowest part of the circuit was determined to be located above the Hisian bifurcation, as multiple episodes with either a right or left bundle branch configuration during tachycardia did not modify the HH cycle. The ventricular septum summit was determined not to be involved, as no preexcitation was present during tachycardia or atrial pacing, and the right bundle branch was not part of the circuit. Radiofrequency current applied beneath the tricuspid valve at the His region successfully eliminated the nodofascicular connection with preservation of 1:1 AV conduction. The anatomical substrate underlying the abnormal connection may be either nodofasciculoventricular Mahaim fibers or a duality or dispersion of the nodo‐Hisian conducting system.</div></front></TEI><affiliations><list><country><li>France</li><li>Portugal</li><li>États-Unis</li></country><region><li>Arizona</li></region></list><tree><country name="France"><noRegion><name sortKey="Haissaguerre, Michel" sort="Haissaguerre, Michel" uniqKey="Haissaguerre M" first="Michel" last="Haïssaguerre">Michel Haïssaguerre</name></noRegion><name sortKey="Clementy, Jacques" sort="Clementy, Jacques" uniqKey="Clementy J" first="Jacques" last="Clémenty">Jacques Clémenty</name><name sortKey="Papouin, Gerard" sort="Papouin, Gerard" uniqKey="Papouin G" first="Gérard" last="Papouin">Gérard Papouin</name></country><country name="Portugal"><noRegion><name sortKey="Campos, Julio" sort="Campos, Julio" uniqKey="Campos J" first="Julio" last="Campos">Julio Campos</name></noRegion></country><country name="États-Unis"><region name="Arizona"><name sortKey="Marcus, Frank I" sort="Marcus, Frank I" uniqKey="Marcus F" first="Frank I." last="Marcus">Frank I. 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