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Ned Tijdschr Geneeskd 2022 03 17;166. Epub 2022 Mar 17.

Franciscus Gasthuis & Vlietland, afd. Cardiologie, Rotterdam.

Background: The case gives the reader a valuable insight in pathophysiology and treatment in atrioventricular nodal re-entry tachycardia (AVNRT) and vagal manoeuvres available to treat this phenomenon.

Case Description: A 85-year-old woman with a medical history of heart failure and aortic valve stenosis presents herself on the Emergency Department with cardiac shock and cardiac asthma. The ECG showed an AVNRT with 170 beats per minute (bpm) and a left bundle branch block (LBBB). Read More

J Ayub Med Coll Abbottabad 2022 Jan-Mar;34(1):49-52

Cardiology Department, MTI, Mardan Medical College, Mardan, Pakistan.

Background: Vagal Maneuver is an underutilized strategy for Cardioversion of Atrioventricular nodal reentrant tachycardia. The present study is an attempt to explore the effectiveness of this strategy.

Methods: This comparative cross-sectional study was performed at the Department of Cardiology MTI MMC Mardan from the first January 2017 to 31 December 2019. Read More

J Cardiovasc Electrophysiol 2022 May 31;33(5):1051-1054. Epub 2022 Mar 31.

Department of Cardiology, Health Sciences University, Ankara City Hospital, Ankara, Turkey.

J Interv Card Electrophysiol 2022 Jan 19. Epub 2022 Jan 19.

2nd Department of Internal Medicine and Cardiology Centre, Medical School, University of Szeged, Semmelweis u. 8., H-6725,, Szeged, Hungary.

Purpose: Radiofrequency (RF) catheter ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is highly effective; however, it may require prolonged fluoroscopy and RF time. We postulated that visualization of the SP region with intracardiac echocardiography (ICE) could decrease ablation time, minimize radiation exposure, and facilitate SP ablation compared to the standard, fluoroscopy-guided approach.

Methods: In our study, we randomized 91 patients undergoing electrophysiologic study and SP ablation for AVNRT into 2 groups: fluoroscopy-only (n = 48) or ICE-guided (n = 43) group. Read More

BMC Cardiovasc Disord 2021 12 25;21(1):611. Epub 2021 Dec 25.

Department of Cardiology, Medical University of Graz, Graz, Austria.

Background: Post-cardiac injury syndrome (PCIS) is an inflammatory condition following myocardial or pericardial damage. In response to catheter ablation, PCIS most frequently occurs after extensive radiofrequency (RF) ablation of large areas of atrial myocardium. Minor myocardial injury from right septal slow pathway ablation for atrioventricular nodal reentrant tachycardia (AVNRT) is not an established cause of the syndrome. Read More

J Cardiovasc Electrophysiol 2022 02 21;33(2):323. Epub 2021 Dec 21.

Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.

J Cardiovasc Electrophysiol 2022 02 18;33(2):322. Epub 2021 Dec 18.

Department of Cardiology, Desun Hospital, Kolkata, India.

Adv Clin Exp Med 2021 Dec;30(12):1323-1328

Department of Emergency Medical Service, Wroclaw Medical University, Poland.

Background: The ST-segment is part of the electrocardiogram and physiologically, it forms an isoelectric line. The ST-segment depression is often observed in young, healthy people with paroxysmal tachycardia with narrow QRS complexes. In this group of patients, the 'mysterious tachycardia-induced ST-segment depression', 'subendocardial myocardial ischemia' and other not fully understood terms are used to explain this phenomenon. Read More

J Interv Card Electrophysiol 2021 Oct 25. Epub 2021 Oct 25.

Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Department of Paediatric Cardiology and Cardiac Surgery (European Reference Network for Rare and Low Prevalence Complex Disease of the Heart - ERN-Guard Heart), Bambino Gesù Children's Hospital IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy.

Purpose: Different authors have described three-dimensional (3D) voltage mapping of the Koch's triangle (KT) in order to find low-voltage bridges (LVB) as targets for a successful transcatheter ablation (TCA) of the slow pathway (SP) in children. Recently, the Advisor High Density (HD) Grid™ mapping catheter was introduced as new multipolar catheter for HD mapping. The aim of the study was to describe our preliminary experience with the use of HD Grid™ catheter in LVB and electrophysiologically guided cryoablation of SP in children. Read More

Int J Cardiol Heart Vasc 2021 Dec 1;37:100881. Epub 2021 Oct 1.

Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.

Background: Catheter ablation (CA) is the first-choice treatment for tachyarrhythmia in children. Currently available CA techniques differ in mechanism of catheter navigation and energy sources. There are no large studies comparing long-term outcomes between available CA techniques in a pediatric population with atrioventricular reentry tachycardia (AVRT) or atrioventricular nodal reentry tachycardia (AVNRT) mechanisms. Read More

Pacing Clin Electrophysiol 2021 Dec 23;44(12):2041-2045. Epub 2021 Nov 23.

Cardiovascular Research Center of Mazandaran University of Medical Science, Sari, Iran.

Background: Apart from junctional rhythms during slow pathway ablation, there is limited knowledge about the junctional tachycardia persisting following ablation cessation. This study is conducted to determine the characteristics and significance of this rare arrhythmia.

Methods And Results: This study was done on 487 patients with AVNRT undergoing the radiofrequency ablation. Read More

Heart Rhythm 2022 02 30;19(2):262-269. Epub 2021 Sep 30.

Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California.

Background: Cryoablation is increasingly used to treat atrioventricular nodal reentrant tachycardia (AVNRT) due to its safety profile. However, cryoablation may have higher recurrence than radiofrequency ablation (RFA), and the optimal procedural endpoint remains undefined.

Objective: The purpose of this study was to identify the association of cryoablation procedural endpoints with postprocedural AVNRT recurrence. Read More

J Cardiovasc Electrophysiol 2021 12 4;32(12):3135-3142. Epub 2021 Oct 4.

Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.

Introduction: Cryoablation has emerged as an alternative to radiofrequency ablation for treating atrioventricular nodal reentrant tachycardia (AVNRT). The aim of this prospective study was to evaluate the efficacy and safety of cryoapplication at sites within the mid/high septal region of Koch's triangle and the relation between sites of transient AV block (AVB) and sites of successful cryoablation.

Methods And Results: Included were 45 consecutive patients undergoing slow-fast AVNRT cryoablation. Read More

Cardiol J 2021 Sep 28. Epub 2021 Sep 28.

Arrhythmia and Electrophysiology, Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland.

Background: His bundle (HB) potentials vary in amplitude and duration in patients with and without slow pathways. The aim of this study was to determine the characteristics of HB potentials and to elucidate whether they can provide clues for identification of slow pathway (SP).

Methods: The present research prospectively studied the electrophysiological findings of 162 patients with symptomatic atrioventricular nodal reentrant tachycardia (AVNRT) due to slow-fast or fast-slow type and atrioventricular reentrant tachycardia (AVRT). Read More

Pol Arch Intern Med 2021 11 28;131(11). Epub 2021 Sep 28.

ELMedica EP-Network, Kielce, Poland

Introduction: Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common regular supraventricular arrhythmias referred for catheter ablation (CA). In Poland, several families with familial AVNRT (FAVNRT) were reported in Podkarpacie Province (PP). Objectives: We aimed to determine the frequency of FAVNRT in PP compared with other south-eastern provinces of Poland. Read More

J Cardiovasc Electrophysiol 2021 11 22;32(11):2979-2986. Epub 2021 Sep 22.

Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Introduction: We tested our hypothesis that atrial entrainment pacing (EP) of a) the common-type (com-) fast-slow (F/S-) atypical atrioventricular nodal reentrant tachycardia (AVNRT) using a typical slow pathway (SP), or b) the superior-type (sup-) F/S-AVNRT using a superior SP, both modify the retrograde conduction time across the SP immediately after termination of EP (retro-SP-time).

Methods: We measured the difference in the His-atrial interval (HA difference) immediately after cessation of EP, performed at 2 ± 2 rates from the high right atrium (HA[1]-HRA) versus from the proximal coronary sinus (HA[1]-CS) in 17 patients with com-F/S-AVNRT and 11 patients with sup-F/S-AVNRT. We also measured the atrial-His and HA intervals of the first and second cycles immediately after cessation of EP and during stable tachycardia. Read More

J Cardiovasc Electrophysiol 2021 11 22;32(11):2971-2978. Epub 2021 Sep 22.

Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden.

Aim: Data on ablation for atypical recurrent atrioventricular nodal reentry tachycardia (AVNRT) and long-term follow-up are generally sparse. Furthermore, the rate of recurrence and safety of cryoablation for atypical AVNRT has not been established. We compared patients cryoablated for atypical AVNRT and typical AVNRT during long-term follow-up. Read More

J Interv Card Electrophysiol 2021 Sep 17. Epub 2021 Sep 17.

Section of Electrophysiology, Cardiology Division, University of Colorado, Aurora, CO, 80045, USA.

Purpose: The incidence of atrial flutter following radiofrequency ablation of supraventricular tachycardias is poorly understood. Ablation of atrioventricular nodal reentry tachycardia may place patients at risk of flutter because ablation of the slow pathway is in close proximity to the cavotricuspid isthmus. This study aims to evaluate the risk of atrial flutter following ablation of atrioventricular nodal reentry tachycardia relative to ablation of other supraventricular tachycardias. Read More

Turk Kardiyol Dern Ars 2021 Sep;49(6):456-462

Department of Cardiology, Liv Hospital, Ankara, Turkey.

Objective: Catheter ablation following electrophysiologic study (EPS) is the mainstay of diagnosis and treatment for patients with atrioventricular reentrant tachycardia (AVRT), demonstrating excellent long-term outcome and a low rate of complications. In this study, our aim was to assess our experience in patients with accessory pathway (AP) and to compare our data with the literature.

Methods: We included 1,437 patients who were diagnosed and treated for AP in our hospital between 1998 and 2020. Read More

Pacing Clin Electrophysiol 2021 Sep 28;44(9):1497-1503. Epub 2021 Aug 28.

Department of Clinical Therapeutics, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, 11528, Greece.

Background: Radiofrequency catheter ablation remains the most effective management option for atrioventricular nodal reentry tachycardia (AVNRT). The risk of atrioventricular (AV) block requiring permanent pacemaker is substantial, but, currently, a reliable method to predict this complication is lacking.

Methods: The electrophysiologic studies (EPS) and baseline characteristics of patients who underwent catheter ablation for the treatment of AVNRT were retrospectively analyzed to investigate predisposing factors for AV block after treatment. Read More

Europace 2021 10;23(10):1596-1602

Biosciences Institute, Newcastle University, Newcastle upon Tyne, UK.

Aims: The exact circuit of atrioventricular nodal re-entrant tachycardia (AVNRT) remains elusive. To assess the location and dimensions of the AVNRT circuit.

Methods And Results: Both typical and atypical AVNRT were induced at electrophysiology study of 14 patients. Read More

Pacing Clin Electrophysiol 2021 Aug 6;44(8):1387-1396. Epub 2021 Jul 6.

Department of Cardiology, Iskenderun Gelişim Hospital, Hatay, Turkey.

Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is the most common supraventriculer arrhythmia in daily clinical practice. Comorbidity of AVNRT and atrial fibrillation (AF) has been well documented in some patients and AF development has been observed more frequently in AVNRT patients during their long-term follow-up. This study was conducted in order to investigate the left atrial two-dimensional-speckle-tracking echocardiographic (STE) parametres as the predictors of the occurence of AF in long-term follow-up in patients with spontaneously developed AF during AVNRT ablation. Read More

Environ Sci Technol 2021 06 3;55(12):8203-8214. Epub 2021 Jun 3.

Consulting Pathologist, Mexico City 04310, México.

Air pollution exposure is a risk factor for arrhythmia. The atrioventricular (AV) conduction axis is key for the passage of electrical signals to ventricles. We investigated whether environmental nanoparticles (NPs) reach the AV axis and whether they are associated with ultrastructural cell damage. Read More

Pacing Clin Electrophysiol 2021 Jul 14;44(7):1200-1206. Epub 2021 Jun 14.

Department of Pediatrics, University of Hacettepe, Ankara, Turkey.

Background: In pediatric patients with documented narrow QRS tachycardia that is suggestive of atrioventricular nodal reentrant tachycardia (AVNRT) and not inducible in electrophysiological study (EPS), empiric slowpathway ablation (ESPA) may be considered. There is limited data in children about this topic.

Methods: Seventy-nine patients who underwent cryoablation and/or radiofrequency ablation (RFA) for presumed AVNRT between January 2010 and January 2020, with no inducible tachycardia and no other tachycardia mechanisms during EPS, were included in this study. Read More

J Electrocardiol 2021 Jul-Aug;67:7-10. Epub 2021 Apr 21.

Cardiology Department, Asklepeion General Hospital, Athens, Greece.

We describe the case of a young patient with runs of repetitive monomorphic left ventricular tachycardia. He was diagnosed with verapamil-sensitive, idiopathic left ventricular tachycardia (ILVT) and underwent an electrophysiological study, in which dual atrioventricular (AV) nodal physiology was evident, with an AV nodal reentrant tachycardia (AVNRT) being easily and reproducibly induced. Both the AVNRT and the ILVT were successfully ablated using high-density electroanatomical mapping and an open-irrigation catheter. Read More

J Cardiovasc Electrophysiol 2021 06 16;32(6):1772-1777. Epub 2021 May 16.

Department of Cardiology, Saint Joseph Hospital CHI Commonspirit, Lexington, Kentucky, USA.

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common sustained supraventricular arrhythmias. An understanding of gender-related differences in AVNRT epidemiology, diagnosis, treatment, outcome, and complications can help guide a more effective diagnosis and treatment of the condition. The study aimed to perform a review of the available literature regarding all aspects of gender-related differences of AVNRT. Read More

J Interv Card Electrophysiol 2022 Mar 19;63(2):323-331. Epub 2021 Apr 19.

2nd Department of Internal Medicine and Cardiology Centre, Medical School, University of Szeged, Semmelweis u. 8, Szeged, H-6725, Hungary.

Purpose: Various ventricular pacing maneuvers have been developed to differentiate orthodromic reciprocating tachycardia (ORT) from atrioventricular nodal reentry tachycardia (AVNRT). We aimed to evaluate the diagnostic value of ventricular pacing maneuvers in patients undergoing catheter ablation for AVNRT/ORT.

Methods: Sixty patients with supraventricular tachycardia (SVT) undergoing invasive EP study were included (ORT: 31, typical AVNRT: 18, atypical AVNRT: 11). Read More

J Cardiovasc Electrophysiol 2021 07 3;32(7):1886-1893. Epub 2021 May 3.

Department of Cardiology, The Baker Heart & Diabetes Institute, Melbourne, Australia.

Background: Catheter ablation is highly effective for atrioventricular nodal re-entrant tachycardia (AVNRT). Generally junctional rhythm (JR) is an accepted requirement for successful ablation however there is a lack of detailed prospective studies to determine the characteristics of JR and the impact on slow pathway conduction.

Methods: Multicentre prospective observational study evaluating the impact of individual radiofrequency (RF) applications in typical AVNRT (slow/fast). Read More

J Cardiovasc Electrophysiol 2021 06 21;32(6):1754-1756. Epub 2021 Apr 21.

Arrhythmia & Electrophysiology Center, IRCCS - MultiMedica Group, Milan, Italy.

J Cardiovasc Electrophysiol 2021 06 21;32(6):1658-1664. Epub 2021 Apr 21.

Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA.

Background: Catheter ablation is considered the first-line treatment of symptomatic atrioventricular nodal reentrant tachycardia (AVNRT). It has been associated with a risk of heart block (HB) requiring a pacemaker. This study aims to determine potential clinical predictors of complete heart block as a result AVNRT ablation. Read More