Adenosine‐Sensitive Atrial Reentrant Tachycardia Originating from the Atrioventricular Nodal Transitional Area
Identifieur interne : 002059 ( Main/Exploration ); précédent : 002058; suivant : 002060Adenosine‐Sensitive Atrial Reentrant Tachycardia Originating from the Atrioventricular Nodal Transitional Area
Auteurs : Yoshito Iesaka ; Atsushi Takahashi ; Masahiko Goya ; Yohkoh Soejima ; Yoshihiro Okamoto ; Hideomi Fujiwara ; Kazutaka Aonuma [Japon] ; Akihtko Nogami [Japon] ; Michiaki Hiroe [Japon] ; Fumiaki Marumo [Japon] ; Masayasu Hiraoka [Japon]Source :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1997-08.
English descriptors
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Abstract
Adenosine‐Sensitive AT from AVN Area. Introduction: Atrial tachycardia shows wide variations in its electrophysiologic properties and sites of origin. We report an atrial tachycardia with ECG manifestations and electrophysiologic characteristics similar to an atypical form of AV nodal reentrant tachycardia (AVNRT). Methods and Results: This supraventricular tachycardia was observed in 11 patients. It was initiated by atrial extrastimulation with an inverse relationship between the coupling interval of an extrastimulus and the postextrastimulus interval. Its induction was not related to a jump in the AH interval, and its perpetuation was independent of conduction block in the AV node. Ventricular pacing during tachycardia demonstrated AV dissociation without affecting the atrial cycle length. A very small dose of adenosine triphosphate (mean 3.9 ± 1.2 mg) could terminate the tachycardia. The earliest atrial activation during tachycardia was recorded at the low anteroseptal right atrium with a different intra‐atrial activation sequence from that recorded during ventricular pacing, where the tachycardia was successfully ablated in 9 of 10 attempted patients. Bidirectional AV nodal conduction remained unatttched after successful ablation. Conclusion: There may he an entity of adenosine‐sensitive atrial tachycardia probably due to focal reentry within the AV node or its transitional tissues without involvement of the AV nodal pathways. This tachycardia can he ablated without disturbing AV nodal conduction from the right atrial septum.
Url:
DOI: 10.1111/j.1540-8167.1997.tb00846.x
Affiliations:
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Introduction: Atrial tachycardia shows wide variations in its electrophysiologic properties and sites of origin. We report an atrial tachycardia with ECG manifestations and electrophysiologic characteristics similar to an atypical form of AV nodal reentrant tachycardia (AVNRT). Methods and Results: This supraventricular tachycardia was observed in 11 patients. It was initiated by atrial extrastimulation with an inverse relationship between the coupling interval of an extrastimulus and the postextrastimulus interval. Its induction was not related to a jump in the AH interval, and its perpetuation was independent of conduction block in the AV node. Ventricular pacing during tachycardia demonstrated AV dissociation without affecting the atrial cycle length. A very small dose of adenosine triphosphate (mean 3.9 ± 1.2 mg) could terminate the tachycardia. The earliest atrial activation during tachycardia was recorded at the low anteroseptal right atrium with a different intra‐atrial activation sequence from that recorded during ventricular pacing, where the tachycardia was successfully ablated in 9 of 10 attempted patients. Bidirectional AV nodal conduction remained unatttched after successful ablation. Conclusion: There may he an entity of adenosine‐sensitive atrial tachycardia probably due to focal reentry within the AV node or its transitional tissues without involvement of the AV nodal pathways. This tachycardia can he ablated without disturbing AV nodal conduction from the right atrial septum.</div></front></TEI><affiliations><list><country><li>Japon</li></country><settlement><li>Tokyo</li></settlement></list><tree><noCountry><name sortKey="Fujiwara, Hideomi" sort="Fujiwara, Hideomi" uniqKey="Fujiwara H" first="Hideomi" last="Fujiwara">Hideomi Fujiwara</name><name sortKey="Goya, Masahiko" sort="Goya, Masahiko" uniqKey="Goya M" first="Masahiko" last="Goya">Masahiko Goya</name><name sortKey="Iesaka, Yoshito" sort="Iesaka, Yoshito" uniqKey="Iesaka Y" first="Yoshito" last="Iesaka">Yoshito Iesaka</name><name sortKey="Okamoto, Yoshihiro" sort="Okamoto, Yoshihiro" uniqKey="Okamoto Y" first="Yoshihiro" last="Okamoto">Yoshihiro Okamoto</name><name sortKey="Soejima, Yohkoh" sort="Soejima, Yohkoh" uniqKey="Soejima Y" first="Yohkoh" last="Soejima">Yohkoh Soejima</name><name sortKey="Takahashi, Atsushi" sort="Takahashi, Atsushi" uniqKey="Takahashi A" first="Atsushi" last="Takahashi">Atsushi Takahashi</name></noCountry><country name="Japon"><noRegion><name sortKey="Aonuma, Kazutaka" sort="Aonuma, Kazutaka" uniqKey="Aonuma K" first="Kazutaka" last="Aonuma">Kazutaka Aonuma</name></noRegion><name sortKey="Hiraoka, Masayasu" sort="Hiraoka, Masayasu" uniqKey="Hiraoka M" first="Masayasu" last="Hiraoka">Masayasu Hiraoka</name><name sortKey="Hiroe, Michiaki" sort="Hiroe, Michiaki" uniqKey="Hiroe M" first="Michiaki" last="Hiroe">Michiaki Hiroe</name><name sortKey="Marumo, Fumiaki" sort="Marumo, Fumiaki" uniqKey="Marumo F" first="Fumiaki" last="Marumo">Fumiaki Marumo</name><name sortKey="Nogami, Akihtko" sort="Nogami, Akihtko" uniqKey="Nogami A" first="Akihtko" last="Nogami">Akihtko Nogami</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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