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Arnold J Greenspon - One of the best experts on this subject based on the ideXlab platform.

  • differentiating Atrioventricular nodal Reentrant Tachycardia from Atrioventricular Reentrant Tachycardia by δha values during entrainment from the ventricle
    Heart Rhythm, 2008
    Co-Authors: George E Mark, Eugene S Rhim, Behzad B Pavri, Arnold J Greenspon
    Abstract:

    Background Differentiating Atrioventricular nodal Reentrant Tachycardia (AVNRT) from orthodromic Atrioventricular Reentrant Tachycardia (AVRT) can be difficult. The His bundle and atria are activated sequentially over the AV node during entrainment of AVNRT from the ventricle but simultaneously during supraventricular Tachycardia (SVT). They are activated in parallel during entrainment of AVRT but sequentially during SVT. Objective The purpose of this study was to test the hypothesis that a ΔHA (HA(entrainment) – HA(SVT)) cutoff value of 0 reliably differentiates AVNRT from AVRT. Methods and Results Of 61 patients undergoing electrophysiologic evaluation for paroxysmal SVT, retrograde His-bundle potentials were recorded in 57 (93%) and entrainment performed in 49 (34 AVNRT, 15 AVRT). ΔHA values during entrainment from the ventricle were significantly longer during AVNRT than AVRT (31 ± 24 ms vs –38 ± 31 ms, P Conclusion The ΔHA criterion during entrainment of Tachycardia from the ventricle reliably differentiates AVNRT (positive values) from AVRT (negative values).

  • Differentiating Atrioventricular nodal Reentrant Tachycardia from Atrioventricular Reentrant Tachycardia by ΔHA values during entrainment from the ventricle
    Heart rhythm, 2007
    Co-Authors: George E Mark, Eugene S Rhim, Behzad B Pavri, Arnold J Greenspon
    Abstract:

    Differentiating Atrioventricular nodal Reentrant Tachycardia (AVNRT) from orthodromic Atrioventricular Reentrant Tachycardia (AVRT) can be difficult. The His bundle and atria are activated sequentially over the AV node during entrainment of AVNRT from the ventricle but simultaneously during supraventricular Tachycardia (SVT). They are activated in parallel during entrainment of AVRT but sequentially during SVT. The purpose of this study was to test the hypothesis that a DeltaHA (HA((entrainment)) - HA((SVT))) cutoff value of 0 reliably differentiates AVNRT from AVRT. Of 61 patients undergoing electrophysiologic evaluation for paroxysmal SVT, retrograde His-bundle potentials were recorded in 57 (93%) and entrainment performed in 49 (34 AVNRT, 15 AVRT). DeltaHA values during entrainment from the ventricle were significantly longer during AVNRT than AVRT (31 +/- 24 ms vs -38 +/- 31 ms, P <.001). All DeltaHA values were positive (minimum: 3 ms) for AVNRT and negative (maximum: -2 ms) for AVRT. DeltaHA of 0 had sensitivity, specificity. and positive predictive value of 100% for correct diagnosis. The DeltaHA criterion during entrainment of Tachycardia from the ventricle reliably differentiates AVNRT (positive values) from AVRT (negative values).

Ranjan K. Thakur - One of the best experts on this subject based on the ideXlab platform.

  • Atrioventricular Reentrant Tachycardia
    Cardiac Electrophysiology, 2020
    Co-Authors: Waseem Barham, Ranjan K. Thakur
    Abstract:

    A 19-year-old female underwent EP study for symptomatic SVT. Ventricular pacing demonstrated eccentric conduction was present. Diagnosis of AVRT with left-sided accessory pathway was reached while other SVT types were excluded. Ablation was successful after mapping the mitral ring via a transseptal approach.

  • Effect of Dual Atrioventricular Node Pathways on Atrioventricular Reentrant Tachycardia
    Circulation, 1995
    Co-Authors: Zoltán Csanádi, George J. Klein, Raymond Yee, Ranjan K. Thakur
    Abstract:

    Dual Atrioventricular (AV) node pathway physiology is frequently observed in patients with AV accessory pathways. To examine the implications of this, we identified 36 patients (19 men and 17 women; mean +/- SD age, 30 +/- 13 years) with both phenomena. The 36 patients had 48 accessory pathways. Twenty-seven patients had bidirectional and 9 had unidirectional accessory pathways. Of the 34 patients with inducible Atrioventricular reentry, 17 used the slow and 11 used the fast anterograde AV node pathway exclusively during AV Reentrant Tachycardia, whereas 6 patients used both the fast and the slow AV node pathways. AV node Reentrant Tachycardia was inducible in addition to AV reentry in 7 patients. Both the cycle length and AH intervals were significantly longer during slow pathway-dependent (cycle length, 411 +/- 58 milliseconds [ms]; AH, 229 +/- 42 ms) than during fast pathway-dependent (cycle length, 322 +/- 40 ms; AH, 121 +/- 25 ms; P < .05) Reentrant Tachycardias. Two patients had only AV node Reentrant Tachycardia inducible despite the presence of the accessory pathway. Four patients with technically difficult accessory pathways were managed by AV node modification with slow pathway (3) or fast pathway (1) ablation. Three of them remained free of symptoms 7, 14, and 25 months after the procedure whereas 1 patient had recurrence of arrhythmia. AV reentrance with dual AV node pathways frequently depends exclusively on either the slow or the fast AV node pathway for clinical Tachycardia. This may provide additional options for ablation in technically difficult cases when the accessory pathway is not otherwise problematic.

  • effect of dual Atrioventricular node pathways on Atrioventricular Reentrant Tachycardia
    Circulation, 1995
    Co-Authors: Zoltán Csanádi, George J. Klein, Raymond Yee, Ranjan K. Thakur
    Abstract:

    Background Dual Atrioventricular (AV) node pathway physiology is frequently observed in patients with AV accessory pathways. Methods and Results To examine the implications of this, we identified 36 patients (19 men and 17 women; mean±SD age, 30±13 years) with both phenomena. The 36 patients had 48 accessory pathways. Twenty-seven patients had bidirectional and 9 had unidirectional accessory pathways. Of the 34 patients with inducible Atrioventricular reentry, 17 used the slow and 11 used the fast anterograde AV node pathway exclusively during AV Reentrant Tachycardia, whereas 6 patients used both the fast and the slow AV node pathways. AV node Reentrant Tachycardia was inducible in addition to AV reentry in 7 patients. Both the cycle length and AH intervals were significantly longer during slow pathway–dependent (cycle length, 411±58 milliseconds [ms]; AH, 229±42 ms) than during fast pathway–dependent (cycle length, 322±40 ms; AH, 121±25 ms; P<.05) Reentrant Tachycardias. Two patients had only AV node re...

San-jou Yeh - One of the best experts on this subject based on the ideXlab platform.

  • Risk factors of recurrence and complication in radiofrequency catheter ablation of Atrioventricular Reentrant Tachycardia in children and adolescents.
    Cardiology in the young, 2013
    Co-Authors: Tien H. Chen, Ming-lung Tsai, Po-cheng Chang, Chung-chuan Chou, Ming-shien Wen, Chun-chieh Wang, San-jou Yeh
    Abstract:

    To compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic Atrioventricular Reentrant Tachycardia in children and adolescents. We retrospectively reviewed the data of 213 consecutive patients with symptomatic Atrioventricular Reentrant Tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age < 12 years) and adolescents (12 < or = rage, 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups. The position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children. The findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of Atrioventricular Reentrant Tachycardia in children and adolescents.

  • Usefulness of predischarge electrophysiologic study in predicting late outcome after surgical ablation of the accessory pathway in the Wolff-Parkinson-White syndrome.
    The American journal of cardiology, 1992
    Co-Authors: San-jou Yeh, Chun-chieh Wang, Fun-chung Lin, Jen-ping Chang, Chau-hsiung Chang
    Abstract:

    A predischarge electrophysiologic study was performed in 113 patients with the Wolff-Parkinson-White (WPW) syndrome who had undergone surgical ablation of the accessory pathway. The study was performed 5 to 20 (mean 10 +/- 3) days after surgery. There were 82 male and 31 female patients (aged 4 to 58 years, mean 36 +/- 13). Sixty-one patients (54%) had manifest, 52 (46%) had concealed and 12 (11%) had multiple accessory pathways. All but 1 patient had Atrioventricular Reentrant Tachycardia incorporating single or multiple accessory pathways during the control electrophysiologic study. The accessory pathways were located in the left ventricular free wall in 60% of cases, right ventricular free wall in 22%, posteroseptum in 13%, and anteroseptum in 5%. The predischarge electrophysiologic study showed that the accessory pathway was capable of anterograde and retrograde conductions in 4 patients (all with manifest WPW syndrome). Four patients showed induction of supraventricular Tachycardia, including 2 with Atrioventricular Reentrant Tachycardia, and 2 with Atrioventricular nodal Reentrant Tachycardia. Recurrence of supraventricular Tachycardia was noted in 5 patients during a follow-up of 28 +/- 26 months. Of these 5 patients, 2 had inducible and 3 had no inducible supraventricular Tachycardia during the predischarge electrophysiologic study.(ABSTRACT TRUNCATED AT 250 WORDS)

Susumu Ito - One of the best experts on this subject based on the ideXlab platform.

  • Catheter ablation therapy in a case with WPW syndrome complicated by multiple tachyarrhythmias.
    The Tokushima journal of experimental medicine, 1993
    Co-Authors: Katsuhito Yamamoto, Shigenobu Bando, Akiyoshi Nishikado, Ikefuji H, Shinohara A, Susumu Ito
    Abstract:

    WPW syndrome is of importance because of the frequent association of tachyarrhythmias. However, its complication by 3 or more different tachyarrhythmias simultaneously is rare. This paper reports a case of WPW syndrome complicated by paroxysmal atrial fibrillation, atrial flutter, and 2 types of Atrioventricular Reentrant Tachycardia. The tachyarrhythmias could be cured by cauterizing the accessory pathway using catheter ablation with radiofrequency electric current. A 30-year-old man visited to a local physician with an episode of Tachycardia which failed to resolve, and a diagnosis of WPW syndrome associated with paroxysmal atrial fibrillation was made. The patient was referred to our hospital for further examination and treatment, and electrophysiological study was performed. During the examination, 2 types of Atrioventricular Reentrant Tachycardia with different heart rates were induced, as well as atrial fibrillation and 2:1 atrial flutter. The presence of a left-sided accessory Atrioventricular pathway was confirmed by coronary sinus mapping, and the following day catheter ablation was performed and the accessory pathway was cauterized. Subsequently, the delta wave disappeared from the ECG and no additional episodes of Tachycardia occurred. Catheter ablation is still undergoing research as a therapeutic modality. However, because the ablation technique entails little invasion or risk, and is economical, it may well become a mainstream treatment for Tachycardia in patients with WPW syndrome in the future.

Chau-hsiung Chang - One of the best experts on this subject based on the ideXlab platform.