Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
Identifieur interne : 002726 ( Main/Corpus ); précédent : 002725; suivant : 002727Involvement of a Nodofascicular Connection in Supraventricular Tachycardia with VA Dissociation
Auteurs : Michel Haïssaguerre ; Julio Campos ; Frank I. Marcus ; Gérard Papouin ; Jacques ClémentySource :
- 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
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ISTEX:BE01CB68866CC8373CC6C86CFE26A660E20FBA48Le document en format XML
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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><istex><corpusName>wiley</corpusName><author><json:item><name>MICHEL HAÏSSAGUERRE M.D.</name><affiliations><json:string>Centre Hospitalier et Universitaire dc Bordeaux. Hôpital Cardiologique du Hant‐Lévéque, Bordeaux‐Pessac, France</json:string></affiliations></json:item><json:item><name>JULIO CAMPOS M.D.</name><affiliations><json:string>Lab. Hemodinamîca, Serviço de Cardiologia, Hospital de S João, Porto, Portugal</json:string></affiliations></json:item><json:item><name>FRANK I. MARCUS M.D.</name><affiliations><json:string>Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona</json:string></affiliations></json:item><json:item><name>GÉRARD PAPOUIN M.D.</name><affiliations><json:string>Centre Hospitalier et Universitaire dc Bordeaux. Hôpital Cardiologique du Hant‐Lévéque, Bordeaux‐Pessac, France</json:string></affiliations></json:item><json:item><name>JACQUES CLÉMENTY M.D.</name><affiliations><json:string>Centre Hospitalier et Universitaire dc Bordeaux. 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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. 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Hôpital Cardiologique du Hant‐Lévéque, Bordeaux‐Pessac, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="case report" displayLabel="caseStudy"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1994-10</dateIssued><edition>Manuscript received 27 July 1994; Accepted for publication 16 September 191994</edition><copyrightDate encoding="w3cdtf">1994</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">45</extent></physicalDescription><abstract 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.</abstract><subject lang="en"><genre>Keywords</genre><topic>supraventricutar tachycardia</topic><topic>accessory pathway</topic><topic>His bundle</topic><topic>Mahaim fibers</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Cardiovascular Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1045-3873</identifier><identifier type="eISSN">1540-8167</identifier><identifier type="DOI">10.1111/(ISSN)1540-8167</identifier><identifier type="PublisherID">JCE</identifier><part><date>1994</date><detail type="volume"><caption>vol.</caption><number>5</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>854</start><end>862</end><total>9</total></extent></part></relatedItem><identifier type="istex">BE01CB68866CC8373CC6C86CFE26A660E20FBA48</identifier><identifier type="DOI">10.1111/j.1540-8167.1994.tb01124.x</identifier><identifier type="ArticleID">JCE854</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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