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J Interv Card Electrophysiol 2021 Apr 19. 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

Praxis (Bern 1994) 2021 ;110(4):189-191

Klinik für Kardiologie, Universitäres Herzzentrum, Universitätsspital Zürich.

CME ECG 68/Answers: Gender Specificities in Heart Rhythm Disorders Sex differences in heart rhythm disorders have been described, especially due to differences of hormone status in women and men. In general, women do have a higher baseline heart rate than men and shorter refractory periods of most structures in the conduction system, except the ventricles. This is particularly apparent in paroxysmal supraventricular tachycardias. Read More

Praxis (Bern 1994) 2021 ;110(3):131-139

Klinik für Kardiologie, Universitäres Herzzentrum, Universitätsspital Zürich.

CME ECG 68: Gender Specificities in Heart Rhythm Disorders Sex differences in heart rhythm disorders have been described, especially due to differences of hormone status in women and men. In general, women do have a higher baseline heart rate than men and shorter refractory periods of most structures in the conduction system, except the ventricles. This is particularly apparent in paroxysmal supraventricular tachycardias. Read More

Int Heart J 2021 Jan 16;62(1):72-77. Epub 2021 Jan 16.

Department of Cardiology II - Electrophysiology, University Hospital Muenster.

Atrioventricular nodal reentry tachycardia (AVNRT) is the most common regular supraventricular tachycardia (SVT). Slow pathway modification (SPM) is the accepted first line treatment with reported success rates around 95%. Information regarding possible predictors of AVNRT recurrence is scarce. Read More

HeartRhythm Case Rep 2020 Dec 13;6(12):960-962. Epub 2020 Oct 13.

Department of Cardiac Electrophysiology, Northwestern Memorial Hospital, Chicago, Illinois.

Curr Opin Cardiol 2021 01;36(1):17-21

Department of Electrophysiology, Banner University Medical Center Phoenix, Phoenix, Arizona.

Purpose Of Review: Atrioventricular node reentrant tachycardia (AVNRT) is the most common mechanism of supraventricular tachycardia. Radiofrequency ablation has been the most prevalent method for slow pathway ablation but carries risk of atrioventricular node injury. Focal cryoablation has been utilized as an alternative ablation modality; however, there has been concern about decreased efficacy, resulting in a higher rate of recurrence postablation. Read More

Future Cardiol 2021 Jan 11;17(1):137-148. Epub 2020 Sep 11.

Assistant Professor, Department of Cardiovascular Technology, School of Allied Health Science (SOAHS), Manipal Academy of Higher Education, Manipal, India 576104.

Atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) are the most common forms of paroxysmal regular supraventricular tachycardias. The clinical, ECG and electrophysiological findings of 121 patients with narrow QRS tachycardia were evaluated prospectively. A total of 75 (62%) of the patients had AVNRT while 46 (38%) had AVRT. Read More

BMC Cardiovasc Disord 2020 08 24;20(1):383. Epub 2020 Aug 24.

Cardiology Department, China-Japan Union Hospital of Jilin University, 126 Xiantai Street, Changchun, Jilin Province, 130033, China.

Background: Variability in the anatomy and orientation of the triangle of Koch (TK) complicates ablation procedures involving the atrioventricular (AV) node. We used CT angiography (CTA) to assess the anatomical TK orientation, the CS ostium direction, and the relationship between the two, and we validated an individualized CS-guided projection during ablation procedures.

Methods: In 104 patients without structural heart disease undergoing computed tomography (CT) angiography, TK orientations were determined in relation to the coronary sinus ostium (CSo) as well as two standard right anterior oblique (RAO) projection angles (30 and 45) commonly used in ablation procedures. Read More

Indian Pacing Electrophysiol J 2020 Nov - Dec;20(6):269-272. Epub 2020 Jun 14.

Cardiology Section, Rainbows Babies and Children's Hospital, Cleveland, OH, USA.

Objectives: The purpose of this study is to assess the prevalence of a His-Atrial-Ventricular (HAV) pattern, i.e. the atrial electrogram following the His bundle -HB- electrogram and preceding the ventricular one, on the catheter placed in the His position in pediatric patients during typical atrioventricular node reentry (AVNRT). Read More

J Cardiovasc Electrophysiol 2020 08 29;31(8):2043-2048. Epub 2020 Jun 29.

Thomas P. Graham Jr. Division of Pediatric Cardiology, Department of Pediatrics, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Introduction: Experience with catheter ablation of orthodromic reciprocating tachycardia (ORT) and atrioventricular nodal reentrant tachycardia (AVNRT) in young children with hypoplastic left heart syndrome (HLHS) is limited. We report the feasibility, safety, and outcomes of catheter ablation of ORT and AVNRT in children with HLHS.

Methods And Results: This was a retrospective review of patients with HLHS who underwent catheter ablation for reentrant supraventricular tachycardias (excluding atrial tachycardias) between 2005 and 2017 at a single center. Read More

J Interv Card Electrophysiol 2020 Jun 9. Epub 2020 Jun 9.

Cardiovascular Surgery Department, University Medical Centre Ljubljana, Zaloška 7, 1000, Ljubljana, Slovenia.

Background: Radiofrequency ablation (RFA) and cryo-ablation (CRA) have been traditionally performed with fluoroscopy which exposes patients and medical staff to the potential harmful effects of the X-ray. Therefore, we aimed to assess the feasibility, safety, and effectiveness of RFA and CRA of atrioventricular nodal reentry tachycardia (AVNRT) guided by the three-dimensional (3D) electro-anatomical mapping (EAM) system without the use of fluoroscopy.

Methods: We analyzed 168 consecutive patients with AVNRT, 62 of whom were under 19 years of age (128 in RFA (age 34. Read More

Clin Transl Med 2020 Jan;10(1):238-257

Department of Cardiology, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.

Background: Atrioventricular nodal reentry tachycardia (AVNRT) is the most common manifestation of paroxysmal supraventricular tachycardia (PSVT). Increasing data have indicated familial clustering and participation of genetic factors in AVNRT, and no pathogenic genes related to AVNRT have been reported.

Methods: Whole-exome sequencing (WES) was performed in 82 patients with AVNRT and 100 controls. Read More

Int J Cardiovasc Imaging 2020 Sep 23;36(9):1599-1607. Epub 2020 May 23.

Second Division of Cardiology, Cardiac-Thoracic-Vascular Department, New Santa Chiara Hospital, Azienda Ospedaliero Universitaria Pisana, Via Paradisa 2, 56124, Pisa, Italy.

To evaluate predictors of zero-X ray procedures for supraventricular arrhythmias (SVT) using minimally fluoroscopic approach (MFA). Patients referred for RF catheter ablation of SVT were admitted for a MFA with an electro-anatomical navigation system or a conventional fluoroscopic approach (ConvA). Exclusion criterion was the need to perform a transseptal puncture. Read More

Heart Surg Forum 2020 03 11;23(2):E114-E117. Epub 2020 Mar 11.

Department of Paediatrics, Renmin Hospital of Wuhan University, Wuhan, China.

Background: We aimed to evaluate the acute and long-term efficacy and safety of radiofrequency catheter ablation (RFCA) in Chinese pediatric patients with arrhythmias.

Methods: We gathered clinical data from pediatric patients who underwent RFCA in several large medical centers in China between 2000 and 2019.

Results: A total of 4,622 different substrates in 4,622 patients were ablated, with the majority consisting of supraventricular tachycardia (N = 3,831, 82. Read More

J Cardiovasc Electrophysiol 2020 06 24;31(6):1420-1429. Epub 2020 Apr 24.

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

Introduction: Electrophysiological properties of reentry circuits of fast-slow atrioventricular nodal reentrant tachycardia (F/S-AVNRT) may contribute to cyclic variability after atrial induction.

Methods: In 156 atrial inductions of 33 patients with F/S-AVNRT, we measured the atrio-His (AH) and His-atrial (HA) intervals in the first cycle after the induction (AH[1] and HA[1], respectively), those in the second cycle (AH [2] and HA [2], respectively), and those during tachycardia that maintained a stable cycle length AH[T] and HA[T], respectively), and calculated the value of AH(1) minus AH(T) [ΔAH] and the value of HA(1) minus HA(T) [ΔHA] in each induction. According to the sum of ΔAH and ΔHA, tachycardia variability was classified as incremental (<-20), balanced (-20 to 20), or decremental (>20). Read More

J Cardiovasc Electrophysiol 2020 06 15;31(6):1430-1435. Epub 2020 Apr 15.

Department of Internal Medicine, Section of Cardiology, Baylor College of Medicine, Houston, Texas.

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is treatable by catheter ablation. Advances in mapping-system technology permit fluoroless workflow during ablations. As national practice trends toward fluoroless approaches, easily obtained, reproducible methods of slow-pathway identification, and ablation become increasingly important. Read More

J Cardiovasc Electrophysiol 2020 06 7;31(6):1563-1564. Epub 2020 Apr 7.

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

Int Heart J 2020;61(2):199-200

Division of Cardiovascular Medicine, Jichi Medical University.

HeartRhythm Case Rep 2020 Jan 30;6(1):8-10. Epub 2019 Sep 30.

Paediatric Cardiology and Cardiac Arrhythmias/Syncope Unit, Bambino Gesu Children's Hospital and Research Institute, Rome, Italy.

Circ Arrhythm Electrophysiol 2020 01 14;13(1):e007796. Epub 2020 Jan 14.

Department of Cardiac Electrophysiology, St. Vincent Medical Group, Cardiac Electrophysiology, Indianapolis, IL.

Background: Current maneuvers for differentiation of atrioventricular node reentry tachycardia (AVNRT) and atrioventricular reentry tachycardia (AVRT) lack sensitivity and specificity for AVRT circuits located away from the site of pacing. We hypothesized that a premature His complex (PHC) will always perturb AVRT because the His bundle is obligatory to the circuit. Further, AVNRT could not be perturbed by a late PHC (≤20 ms ahead of the His) due to the retrograde His conduction time. Read More

J Cardiovasc Electrophysiol 2020 03 15;31(3):733-735. Epub 2020 Jan 15.

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

Int Heart J 2020 Mar 26;61(2):380-383. Epub 2019 Dec 26.

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

We report a case of atypical slow-slow atrioventricular nodal reentrant tachycardia (AVNRT) utilizing a superior slow pathway as a retrograde limb. The standard electrophysiological criteria confirm the diagnosis of this AVNRT by successfully excluding a diagnosis of atrial tachycardia and atrioventricular reentrant tachycardia. The earliest atrial activation during tachycardia was found at the interatrial septum 17. Read More

Indian Pacing Electrophysiol J 2020 Mar - Apr;20(2):70-72. Epub 2019 Dec 16.

Cardiology and Electrophysiology, Jacobi Medical Center, Montefiore Medical Center, United States. Electronic address:

We report a rare case of spontaneous initiation of Atrioventricular nodal reentry tachycardia (AVNRT) via 2 for 1 phenomenon, into a 2:1 AV block due to lower common pathway block and finally transition to 1:1 tachycardia. The premature atrial p wave traverses down both the fast and slow pathway simultaneously during 2 for 1 initiation and is met with subsequent typical AVNRT with 2:1 block. Infranodal location of the block is confirmed on electrophysiologic testing and is also cured by intervention. Read More

J Interv Card Electrophysiol 2020 Nov 9;59(2):393-400. Epub 2019 Dec 9.

Gill Heart Institute and VAMC, Cardiology, University of Kentucky, Lexington, KY, USA.

Introduction: Ventriculoatrial (VA) conduction is a critical component in many arrhythmias, has a diagnostic value in electrophysiology study (EPS), and is implicated in pacemaker-mediated arrhythmias. This study sought to characterize retrograde conduction during EPS and to utilize it as a diagnostic tool in patients without AV block.

Methods And Results: Patients with intact AV conduction undergoing EPS were included in this study to systematically evaluate baseline VA conduction. Read More

J Cardiovasc Electrophysiol 2020 01 1;31(1):137-143. Epub 2019 Dec 1.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.

Background: Limited data are available regarding the demographics, disease associations, and long-term prognosis of patients with inappropriate sinus tachycardia (IST).

Objective: To establish epidemiologic data for patients with IST, including symptom onset, comorbid disease, and long-term outcomes.

Methods: We retrospectively reviewed all patients with an IST diagnosis at the Mayo Clinic (Rochester, MN) during a 20-year period (1998-2018). Read More

Herzschrittmacherther Elektrophysiol 2019 Dec 11;30(4):336-342. Epub 2019 Nov 11.

II. Med. Klinik, Klinik für Kardiologie, Angiologie, Pneumologie, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Deutschland.

Supraventricular tachycardias (SVT) are common, with atrioventricular nodal reentry tachycardias (AVNRT) being the most common paroxysmal supraventricular tachycardia. The pathophysiological understanding and the catheter ablation of SVTs have developed steadily in recent years. For example, dividing AVNRT into "typical" and "atypical" depending on the HA-, VA-interval and AH/HA ratio is recommended. Read More

Medicine (Baltimore) 2019 Oct;98(41):e17333

El-Medica, EP-Network, Kielce.

Patients with structural heart disease (SHD) are more difficult to ablate than those with a structurally healthy heart. The reason may be technical problems. We compared periprocedural data in unselected patients (including SHD group) recruited for zero-fluoroscopy catheter ablation (ZF-CA) of supraventricular arrhythmias (SVTs). Read More

Clin Cardiol 2019 Nov 3;42(11):1121-1125. Epub 2019 Sep 3.

Department for Cardiology II: Electrophysiology, University Hospital Münster, Münster, Germany.

Background: Sarcoidosis is a multisystem granulomatous disease of not sufficiently understood origin. Some patients develop cardiac involvement in course of the disease which is mostly responsible for adverse outcome. In addition to complications like high degree atrioventricular (AV) block or ventricular tachyarrhythmias, there is a certain percentage of patients developing atrial tachyarrhythmias. Read More

Sci Rep 2019 08 13;9(1):11784. Epub 2019 Aug 13.

Department of Cardiology, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common type of supraventricular tachycardia. Slow pathway (SP) ablation is the treatment of choice with a high acute success rate and a negligible periprocedural risk. However, long-term outcome data are scarce. Read More