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Heart Rhythm 2019 Feb 28. Epub 2019 Feb 28.

Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Background: Catheter ablation of the slow pathway is standard treatment for atrioventricular nodal reentry tachycardia (AVNRT), with a well-described, low risk for periprocedural atrioventricular block. Less is known about the risk of pacemaker implantation late after ablation.

Objective: We aimed to quantify the risk of late pacemaker-implantation in a countrywide cohort undergoing first-time ablation for AVNRT. Read More

Eur J Radiol 2019 Jan 20;110:105-111. Epub 2018 Nov 20.

Medical University of Innsbruck, University Clinic of Internal Medicine III / Cardiology and Angiology, Innsbruck, Austria. Electronic address:

Background: Exposure to high doses of radiation during cardiac interventional procedures is associated with increased rates of cataract and cancer in patients and staff members. Thus, reduction of radiation is recommended by international medical societies. The aim of this study was to evaluate, if the lowest reasonable fluoroscopic acquisition setting for electrophysiological procedures using a novel X-ray detector operated at a minimum detector entrance dose per fluoroscopy pulse is feasible and safe. Read More

Scand Cardiovasc J 2018 Dec 25;52(6):362-366. Epub 2019 Jan 25.

a Department of Cardiology , Haukeland University Hospital , Bergen , Norway.

Objectives: Catheter ablation is regarded as first-line therapy for symptomatic atrioventricular nodal reentry tachycardia (AVNRT). Ablation induces intended myocardial damage and the extent of myocardial damage may differ between ablation methods. The objective of this MAGMA AVNRT(NCT00875914) substudy was to compare high-sensitive cardiac troponin T (hs-cTnT) levels as a surrogate marker for myocardial damage after manually guided (MAN) AVNRT ablation versus AVNRT ablation using remote magnetic navigation (RMN). Read More

Scand Cardiovasc J 2018 Oct 9;52(5):268-274. Epub 2019 Jan 9.

a Department of Cardiovascular Sciences , University of Leuven , Leuven , Belgium.

Aim: 3D Rotational angiography (3DRA) allows for detailed reconstruction of atrial anatomy and is often used to facilitate pulmonary vein isolation. This study aimed to reappraise the anatomy of the right atrium (RA) using 3DRA, specifically looking at Koch's triangle and the cavotricuspid isthmus (CTI) in atrio-ventricular reentrant tachycardia (AVNRT) and atrial flutter (AFl) ablation.

Methods And Results: 3DRA was performed in 97 patients: AVNRT = 51 and AFl = 46. Read More

Circ Arrhythm Electrophysiol 2018 Sep;11(9):e006631

Heart Rhythm Institute, University of Oklahoma Health Sciences Center (S.S., W.M.J., D.L., H.N., K.B., K.E., S.S.P.).

Background We describe a technique to localize the ablation target in patients with an unusual variant of slow/fast atrioventricular nodal reentrant tachycardia (AVNRT) using a slow pathway connecting to the basal inferolateral left atrium. Methods Consecutive patients with slow/fast AVNRT were included. During stable slow/fast AVNRT, a single late atrial extrastimulus (AES) was delivered at the inferolateral left atrium near the mitral annulus. Read More

J Interv Card Electrophysiol 2018 Dec 6;53(3):365-371. Epub 2018 Oct 6.

Department of Medicine, Section of Cardiology, Center for Arrhythmia Care, Heart and Vascular Center, University of Chicago Medicine Pritzker School of Medicine, 5841 S. Maryland Avenue, MC 6092, Chicago, IL, 60637, USA.

Purpose: This study aimed to determine the incidence, prevalence, and predictors of atrial arrhythmias (AAs) in patients with symptomatic sinus node dysfunction (SND) who required permanent pacemaker implantation. Also, we evaluated the impact of atrial pacing (AP) on AAs.

Methods: All consecutive patients who underwent pacemaker implantation from 2005 to 2011 were included. Read More

Turk J Emerg Med 2018 Sep 13;18(3):131-133. Epub 2018 Apr 13.

Sisli Hamidiye Etfal Education and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey.

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common type of reentrant paroxysmal supraventricular tachycardia that occurs in the presence of dual AV nodal physiology. Wolff-Parkinson-White (WPW) syndrome is another type of supraventricular tachycardia characterized by short PR intervals, delta waves and wide QRS complexes on the surface electrocardiogram (ECG), reflecting atrioventricular pre-excitation. Uncommonly, AV nodal reentry and accessory pathways can coexist. Read More

Zhonghua Er Ke Za Zhi 2018 Sep;56(9):674-679

Pediatric Cardiologic Department of Tsinghua University First Hospital, Beijing 100016, China.

To investigate the clinical features and evaluate the efficacy of radiofrequency catheter ablation (RFCA) guided by 3D electronic-anatomy mapping system (CARTO3 System) in children with atrioventricular nodal reentrant tachycardia (AVNRT). This was a retrospective case-controlled study. Data were collected from 95 children with AVNRT who underwent RFCA using CARTO3 System in the first hospital of Tsinghua University from January 2014 to December 2017. Read More

J Interv Card Electrophysiol 2018 Jul 21. Epub 2018 Jul 21.

Division of Pediatric Cardiology, University of Nebraska Medical Center/Children's Hospital & Medical Center, 8200 Dodge Street, 4th Floor SPC: Cardiology, Omaha, NE, 68114, USA.

Purpose: Patients with atrioventricular nodal reentry tachycardia (AVNRT) often are managed successfully by ablation of the slow pathway with success rates reported as high as 99%. Low voltage bridges (LVBs) have been demonstrated to be helpful in guiding AVNRT ablation. Patients may present to the electrophysiology lab without evidence of inducible arrhythmia. Read More

J Interv Card Electrophysiol 2018 Aug 16;52(3):271-279. Epub 2018 Jun 16.

Department of Medicine, Division of Cardiology, Weill Cornell Medical Center, 525 East 68th Street, New York, NY, 10065, USA.

In delaying transmission of the cardiac impulse from the atria to the ventricles, the atrioventricular (AV) node serves a critical function in augmenting ventricular filling during diastole and limiting the ventricular response during atrial tachyarrhythmias. The complex structure of the nodal region, however, also provides the substrate for reentrant rhythms. Recent discoveries have elucidated the cellular basis and anatomical determinants of slow conduction in the node. Read More

Card Electrophysiol Clin 2018 06;10(2):277-297

Heart and Vessels Department, University of Florence, Largo Brambilla, 3, Florence 50134, Italy; IRCCS Multimedica, Cardiology Department, Via Milanese, 300, 20099 Sesto San Giovanni, Italy.

Atrioventricular node reentrant tachycardia (AVNRT) is a supraventricular arrhythmia easily diagnosed by 12-lead electrocardiogram. What is far more challenging, is the understanding of the reentrant circuit in its typical and atypical presentations. The function of the atrioventricular node is still incomplete and this knowledge gap is reflected in the reconstruction of the pathways used by AVNRT in its multiform presentations. Read More

Cardiol J 2018 Apr 3. Epub 2018 Apr 3.

University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.

Background: Awareness of risks associated with radiation exposure to patients and medical staff has significantly increased. It has been reported before that the use of advanced three-dimensional electro-anatomical mapping (EAM) system significantly reduces fluoroscopy time, however this study aimed for zero or near zero fluoroscopy ablation to assess its feasibility and safety in ablation of atrial fibrillation (AF) and other tachyarrhythmias in a "real world" experience of a single tertiary care center.

Methods: This was a single-center study where ablation procedures were attempted without fluoroscopy in 34 consecutive patients with different tachyarrhythmias under the support of EAM system. Read More

J Interv Card Electrophysiol 2018 Jul 19;52(2):157-161. Epub 2018 Mar 19.

Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.

Purpose: Slow pathway modulation is the treatment of choice in patients with atrioventricular nodal reentrant tachycardia (AVNRT). No comparative data on ablation strategies exist. Therefore, we sought to compare two common ablation approaches. Read More

Clin Res Cardiol 2018 Jul 23;107(7):578-585. Epub 2018 Feb 23.

Heart and Vascular Centre, Mater Private Hospital, 72 Eccles Street, Dublin 7, Ireland.

Aims: Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs).

Methods: We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center. Read More

Adv Med Sci 2018 Sep 10;63(2):249-256. Epub 2018 Feb 10.

Elmedica, EP-Network, Kielce, Poland; Chair of Electroradiology, Faculty of Medicine, University of Rzeszow, Rzeszow, Poland; Podkarpackie Center for Cardiovascular Intervention, G.V.M. Carint, Sanok, Poland.

Purpose: During incremental atrial pacing in patients with atrioventricular nodal reentrant tachycardia, the PR interval often exceeds the RR interval (PR > RR) during stable 1:1 AV conduction. However, the PR/RR ratio has never been evaluated in a large group of patients with pacing from the proximal coronary sinus and after isoproterenol challenge. Our study validates new site of pacing and easier method of identification of PR > RR. Read More

J Interv Card Electrophysiol 2018 Mar 3;51(2):163-168. Epub 2018 Feb 3.

Washington University School of Medicine/St Louis Children's Hospital, 1 Children's Place, Campus Box 8116, 8th Floor NWT, Saint Louis, MO, 63110, USA.

Purpose: The anatomic basis of atrioventricular node reentrant tachycardia (AVNRT) remains incompletely characterized in children. Differences in coronary sinus (CS) size and morphology have been observed in adults with AVNRT but have not been well characterized in children.

Methods: Children (< 18 years) brought to the EP lab with supraventricular tachycardia for ablation underwent CS venography. Read More

Eur J Hum Genet 2018 05 2;26(5):660-668. Epub 2018 Feb 2.

Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark.

Atrioventricular nodal reentry tachycardia (AVNRT) is the most common form of regular paroxysmal supraventricular tachycardia. This arrhythmia affects women twice as frequently as men, and is often diagnosed in patients <40 years of age. Familial clustering, early onset of symptoms and lack of structural anomaly indicate involvement of genetic factors in AVNRT pathophysiology. Read More

Zhonghua Er Ke Za Zhi 2018 Jan;56(1):13-18

Heart Center, Division of Pediatric Cardiology, First Hospital of Tsinghua University, Beijing 100016, China.

The study assessed the clinical characteristics and response to acute intravenous antiarrhythmic drug therapy of supraventricular tachycardia (SVT) in children. This was a multicenter prospective descriptive study including 257 children from First Hospital of Tsinghua University, Peking University First Hospital, Children's Hospital Affiliated to Capital Institute of Pediatrics and Beijing Anzhen Hospital who received intravenous antiarrhythmic drug therapy for SVT from July 2014 to February 2017. The clinical and tachycardia features, response to intravenous antiarrhythmic drug therapy of these children were characterized. Read More

Pacing Clin Electrophysiol 2018 03 12;41(3):255-260. Epub 2018 Feb 12.

Department of Pediatrics, Pediatric and Genetic Arrhythmia, Center, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey.

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is a common tachyarrhythmia substrate in children, which is successfully treated by catheter ablation using radiofrequency or cryothermal energy. In recent years, cryoablation (Cryo) using electroanatomical system guidance is more commonly preferred for use in children in order to decrease the risk of an atrioventricular block. However, there are concerns regarding the long-term efficacy of Cryo in treating AVNRT. Read More

Korean J Pediatr 2017 Dec 22;60(12):390-394. Epub 2017 Dec 22.

Department of Pediatrics, Kyungpook National University Hospital, Daegu, Korea.

Purpose: Atrioventricular nodal reentry tachycardia (AVNRT) is less common in pediatric patients than in adult patients. Thus, data for pediatric AVNRT patients are insufficient. Hence, we aimed to analyze the patient characteristics, treatment, and any recurrences in pediatric AVNRT patients. Read More

Int Heart J 2018 Jan 20;59(1):71-76. Epub 2017 Dec 20.

The Heart Center, Regions Hospital, St. Paul.

Discrimination between atrioventricular node reentry tachycardia (AVNRT) and orthodromic reciprocating tachycardia (ORT) during an electrophysiological study is sometimes challenging. This study aimed to investigate if the difference in the local VA (ventricle-atrium) interval during ventricular entrainment pacing and during tachycardia (DVA, defined as the shortest local VA interval of coronary sinus [CS] during entrainment minus the shortest local VA interval of CS during tachycardia) was different in patients with AVNRT and patients with ORT.Diagnoses of AVNRT or ORT through a concealed accessory pathway (AP) were made according to conventional electrophysiological criteria and ablation results. Read More

Pacing Clin Electrophysiol 2018 02 16;41(2):182-193. Epub 2018 Jan 16.

Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky and Lexington VAMC, Lexington, KY, USA.

Background: Ablation is an effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). The occurrence of junctional ectopic rhythm (JER), including junctional ectopic tachycardia, following AVNRT ablation has been described as an extremely rare phenomenon, but may be underestimated. We aimed to determine the incidence of JER following AVNRT ablation within our institution, as well as that reported in the literature via an extensive review. Read More

J Emerg Med 2018 Feb 26;54(2):198-206. Epub 2017 Nov 26.

Department of Emergency Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Atrioventricular-nodal-reentry tachycardia (AVNRT) is a form of supraventricular tachycardia (SVT) that is relatively common in the emergency department (ED). It is rarely indicative of underlying electrical or structural pathology.

Objective: This review evaluates the literature and controversies concerning treatment of AVNRT in the ED. Read More

Pacing Clin Electrophysiol 2018 01 28;41(1):7-13. Epub 2017 Dec 28.

Third Department of Cardiology, Hippokration Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Radiofrequency (RF) ablation of the slow pathway (SP) in atrioventricular nodal reentry tachycardia (AVNRT) is occasionally complicated with atrioventricular block (AVB) often predicted by junctional beats (JB) with loss of ventriculo-atrial (VA) conduction.

Methods: We analyzed retrospectively 153 patients undergoing ablation of SP for typical AVNRT. Patients were divided into two age groups: 127 ≤ 70 years and 26 > 70 years. Read More

Zhonghua Xin Xue Guan Bing Za Zhi 2017 Nov;45(11):935-939

First Affiliated Hospital of Dalian Medical University, Dalian 116000, China.

To compare the outcome of radiofrequency catheter ablation under local anesthesia/sedation (S) or general anesthesia(GA) in atrial fibrillation patients. Data of 498 patients with atrial fibrillation undergoing radiofrequency catheter ablation in our departmentfrom January 2014 to December 2015 were retrospectively analyzed. Two hundred and twenty patients assigned to the GA group, the other 278 patients to the S group. Read More

Clin Cardiol 2017 Nov 22;40(11):1112-1115. Epub 2017 Nov 22.

Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.

Background: The first-line therapy for atrioventricular nodal reentry tachycardia (AVNRT) is catheter-based slow pathway modulation. If AVNRT is not inducible during an electrophysiological study, an empirical slow pathway modulation (ESPM) may be considered in patients with dual atrioventricular nodal physiology and/or a typical electrocardiogram (ECG).

Methods: We screened 149 symptomatic patients who underwent ESPM in our department between 1993 and 2013. Read More

J Electrocardiol 2018 Mar - Apr;51(2):338-342. Epub 2017 Oct 5.

Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.

A 71-year-old woman with narrow QRS tachycardia was referred for catheter ablation. The clinical tachycardia was diagnosed as slow/fast form of atrioventricular (AV) nodal reentrant tachycardia (AVNRT) with the upper common pathway. Although neither conventional nor double atrial programmed extrastimulation (APS) showed any evidence of a dual AV nodal pathway, AV simultaneous pacing during basic stimulation preceding APS (AVSP-APS) reproducibly revealed a dual AV nodal pathway as a double ventricular response. Read More

Heart Rhythm 2018 03 26;15(3):421-429. Epub 2017 Nov 26.

University of Chicago Medicine Center for Arrhythmia Care, Heart and Vascular Center, Chicago, Illinois. Electronic address:

Background: Dedicated mapping studies of the triangle of Koch to characterize retrograde fast pathway activation have not been previously performed using high-resolution, 3-dimensional, multielectrode mapping technology.

Objective: To delineate the activation pattern and spatial distribution of the retrograde fast pathway within the triangle of Koch during typical atrioventricular nodal reentrant tachycardia (AVNRT) and right ventricular pacing in a consecutive series of patients using the Rhythmia mapping system (Boston Scientific, Natick, MA).

Methods: A total of 18 patients with symptomatic typical AVNRT referred for ablation underwent ultra high-density mapping of atrial activation with minielectrode basket configuration during tachycardia. Read More

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017 Aug;35(8):614-616

The First Hospital of Shanxi Medical University, Taiyuan 030001, China.

To explore the advantage of radiofrequency catheter ablation under the three-dimensional mapping in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in reducing the X-ray exposure dose of interventional doctors. 79 patients with AVNRT, in the first hospital of Shanxi Medical University from January 2015 to June 2016, performed to do radiofrequency catheter ablation treatment were selected, and according to the random number method were divided into two-dimensional mapping group and three-dimensional mapping group. The two-dimensional mapping group was mapped the ablation target at the X-ray, while the ablation target was mapped by CARTO 3 system in the three-dimensional mapping group. Read More

Indian Pacing Electrophysiol J 2017 Jul - Aug;17(4):95-99. Epub 2017 Jan 6.

Section of Cardiology, Department of Medicine, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Dartmouth, United States. Electronic address:

Background: Most literature for cryoablation of atrioventricular nodal reentry tachycardia (AVNRT) is based on -30 degree celsius cryomapping with 4 & 6 mm distal electrode catheters. The cryomapping mode is not available on the 6 mm cryocatheter in the United States. We describe a technique for 'pseudo' mapping at -80° using a 6 mm cryocatheter and report on short and long term outcomes. Read More

J Cardiovasc Electrophysiol 2018 Jan 10;29(1):167-176. Epub 2017 Nov 10.

Baylor Heart and Vascular Institute, Dallas, TX, USA.

Introduction: Radiofrequency (RF) ablation is effective for slow pathway ablation, but carries a risk of inadvertent AV block requiring permanent pacing. By comparison, cryoablation with a 4-mm distal electrode catheter has not been reported to cause permanent AV block but has been shown to be less effective than RF ablation. We sought to define the safety and efficacy of a 6-mm distal electrode cryoablation catheter for slow pathway ablation in patients with atrioventricular nodal reentry tachycardia (AVNRT). Read More

Clin Res Cardiol 2017 Dec 28;106(12):947-952. Epub 2017 Aug 28.

Department of Electrophysiology, German Heart Center Munich, Lazarettstr. 36, 80636, Munich, Germany.

Background: Remote magnetic navigation (RMN) is attributed to diminish radiation exposure for both patient and operator performing catheter ablation for different arrhythmia substrates. The purpose of this prospective, randomized study was to compare RMN with manually guided catheter ablation for AV nodal reentrant tachycardia (AVNRT) regarding fluoroscopy time/dosage, acute and long-term efficacy as well as safety.

Methods And Results: A total of 218 patients with AVNRT undergoing catheter ablation at three centers (male 34%, mean age 50 ± 17 years) were randomized to a manual approach (n = 113) or RMN (n = 105) using the Niobe magnetic navigation system. Read More

Heart Rhythm 2017 11 8;14(11):1637-1646. Epub 2017 Aug 8.

Heart & Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address:

Background: Atrioventricular nodal reentry tachycardia (AVNRT) is common in adults and often involves reentry through ≥2 atrioventricular nodal-atrial connections. Although AVNRT can be a trigger for atrial fibrillation (AF), we have observed new-onset AVNRT after AF ablation procedures.

Objective: The purpose of this study was to determine whether ablation involving the septum or proximal coronary sinus (CS) during AF ablation may create a substrate favorable for AVNRT. Read More

Arch Cardiovasc Dis 2017 Nov 24;110(11):599-606. Epub 2017 Jul 24.

Adult and Paediatric Cardiology, CHU de Brabois, 42 bis, rue du Colonel-Driant, 54220 Malzéville, France.

Background: Paroxysmal supraventricular tachycardia (SVT) is considered benign in children if the electrocardiogram in sinus rhythm is normal, but causes anxiety in parents, children and doctors.

Aims: To report on the clinical and electrophysiological data from children with SVT, their follow-up and management.

Methods: Overall, 188 children/teenagers (mean age 15±2. Read More

Georgian Med News 2017 Jun(267):61-65

1Jo Ann Medical Center; 2David Tvildiani Medical University, Tbilisi, Georgia; 3Hospital Clinic, University of Barcelona, Spain.

The aim of the study was to evaluate the incidence of different personality types and state and trait anxiety levels in patients with paroxysmal supraventricular tachycardia and their association with patients age, gender and the mechanism of the paroxysmal SVT. 62 patients with documented paroxysmal supraventricular tachycardia who underwent endocardial eletrophysiological study and catheter ablation of the paroxysmal SVT were included in the study. The patients were asked to fill out the Myers-Brigss Type Indicator and State-Trait Anxiety Inventory questionnaires and the results were analyzed and correlated with the arrhythmia mechanism determined during electrophysiological study and catheter ablation procedure, and the patients' demographics (age and gender). Read More

Heart Rhythm 2017 11 14;14(11):1649-1654. Epub 2017 Jul 14.

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

Background: Cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is associated with higher recurrence rates than radiofrequency ablation (RFA). Junctional tachycardia marks procedural success with RFA, but no such indicator exists for cryoablation.

Objective: The purpose of this study as to determine the impact of voltage mapping plus longer ablation lesions on midterm success of cryoablation for children with AVNRT. Read More

Int J Cardiol 2017 Oct 15;244:158-162. Epub 2017 Jun 15.

Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Germany.

Background: Permanent AV-block is a recognized and feared complication of slow pathway modulation for AVNRT. We aimed to assess incidence of transient and permanent AV-block as well as consequences of transient AV-block in a large contemporary AVNRT ablation cohort.

Methods: We searched our single center prospective ablation database for occurrence of transient and permanent AV-block during slow pathway modulation between January 2004 and October 2015. Read More

Pediatr Cardiol 2017 Aug 13;38(6):1220-1225. Epub 2017 Jun 13.

Pediatric and Genetic Arrhythmia Center, Istanbul Medipol University, TEM Avrupa Otoyolu Goztepe Cikisi, No 1, Bagcilar, 14, Istanbul, Turkey.

Due to its safety profile, cryoablation (Cryo) for atrioventricular nodal reentrant tachycardia (AVNRT) is more commonly preferred over radiofrequency (RF) ablation in children in recent years. Recent studies demonstrated high long-term success rates comparable to radiofrequency ablation. The aim of this prospective study was to compare the efficacy and safety of an 8-mm-tip versus 6-mm-tip Cryo catheter in the treatment of AVNRT in children. Read More

Heart Rhythm 2017 11 10;14(11):1615-1622. Epub 2017 Jun 10.

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

Background: The atrial and ventricular response observed immediately after cessation of ventricular induction/entrainment pacing is commonly analyzed to discriminate atrial tachycardia from other supraventricular tachycardias during electrophysiologic studies. However, the response in fast-slow atrioventricular nodal reentrant tachycardia (F/S-AVNRT) remains poorly investigated.

Objective: The purpose of this study was to analyze the atrial and ventricular activation patterns after ventricular pacing in F/S-AVNRT. Read More

Europace 2018 04;20(4):e51-e59

Division of Cardiology, Johns Hopkins University School of Medicine, 1800 Orleans Street, Zayed 7125, Baltimore, MD 21287, USA.

Aims: Historical studies of ablation of atrioventricular nodal re-entrant tachycardia (AVNRT) have shown high long-term success rates and low complication rates. The potential impact of several recent practice trends has not been described. This study aims to characterize recent clinical practice trends in AVNRT ablation and their associated success rates and complications. Read More

Europace 2018 04;20(4):654-658

Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.

Aims: Shortening of the atrial-His bundle (AH) interval during the sinus rhythm is occasionally observed after slow pathway ablation for atrioventricular nodal re-entrant tachycardia (AVNRT). In addition, high-rate atrial pacing is useful for avoiding atrioventricular block. We hypothesized that shortening of the AH interval during slow pathway ablation under high-rate atrial pacing would lead to successful ablation of typical AVNRT. Read More

Clin Case Rep 2017 05 30;5(5):671-674. Epub 2017 Mar 30.

Department of Cardiology Charité - Universitätsmedizin Berlin Campus Virchow-Klinikum Berlin Germany.

A patient developed a transient first-degree AV block during a radiofrequency ablation of an atrioventricular nodal reentrant tachycardia. Three days later the patient presented with a third-degree AV block. It resolved within 24 h under antiphlogistic therapy. Read More

Europace 2017 Apr;19(4):602-606

Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Rd, Baker 4, Boston, MA 02215, USA.

Aims: To conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT).

Methods And Results: Patients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120-300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a 'pill in the pocket' approach. Read More

Europace 2018 04;20(4):665-672

Paediatric Cardiology and Cardiac Arrhythmias/Syncope Unit, Bambino Gesù Children's Hospital and Research Institute, Piazza Sant'Onofrio 4, 00165 Rome, Italy.

Aims: Recently, voltage gradient mapping of Koch's triangle to find low-voltage connections, or 'voltage bridges', corresponding to the anatomic position of the slow pathway, has been introduced as a method to ablate atrioventricular nodal reentry tachycardia (AVNRT) in children. Thus, we aimed to assess the effectiveness of voltage mapping of Koch's triangle, combined with the search for the slow potential signal in 'low-voltage bridges', to guide cryoablation of AVNRT in children.

Methods And Results: From June 2015 to May 2016, 35 consecutive paediatric patients (mean age 12. Read More

Europace 2018 04;20(4):659-664

Kowsar Hospital, Fars Hear Foundation, Shiraz, Iran.

Aims: In previous retrospective studies, it was shown that the presence of residual single atrioventricular node (AVN) echoes with an echo zone longer than 30 ms may increase the rate of recurrence after radiofrequency ablation (RFA) of slow pathway in patients with AVN reentrant tachycardia (AVNRT). Based on that, some centres perform additional RFA in these patients. However, this opinion has never been tested prospectively and many centres do not perform re-ablation in these patients. Read More

Eur Heart J 2017 May;38(17):1317-1326

Stiftung Institut für Herzinfarktforschung (IHF), Ludwigshafen, Germany.

Aims: To analyse outcomes of supraventricular tachycardia (SVT) ablations performed within a prospective German Ablation Quality Registry.

Methods And Results: Data from 12 566 patients who underwent catheter ablation of SVT between January 2007 and January 2010 to treat atrial fibrillation (AFIB, 37.2% of procedures), atrial flutter (AFL, 29. Read More

Heart Lung Circ 2017 Dec 21;26(12):1297-1302. Epub 2017 Feb 21.

Cardiology Department, Westmead Hospital, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address:

Background: The Magnetic Navigation System (MNS) catheter was shown to be stable in the presence of significant cardiac wall motion and delivered more effective lesions compared to manual control. This stability could potentially make AV junctional re-entrant tachycardia (AVNRT) ablation safer. The aim of this study is to describe the method of mapping and ablation of AVNRT with MNS and 3-D electro-anatomical mapping system (CARTO, Biosense Webster, Diamond bar, CA, USA) anatomical mapping, with a view to improve the safety of ablation. Read More

Circ Arrhythm Electrophysiol 2017 Feb;10(2):e004680

From the Department of Cardiology and Tel-Aviv Sourasky Medical Center (Y.M., A.A.-H., O.T.-B., A.G., B.B.), and the Genetic Institute, Meir Medical Center (E.R.), Sackler Faculty of Medicine, Tel-Aviv University, Israel.

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is considered a sporadic disease occurring in ≈22.5 cases per 10 000 in the general population. We define the prevalence and characteristics of familial AVNRT among patients who underwent radiofrequency ablation. Read More

Int J Cardiol 2017 Jun 31;236:198-202. Epub 2017 Jan 31.

Schneider Children's Medical Center Israel, Petach Tikva, and Sackler School of Medicine, Tel Aviv University, Israel.

Background: Limited fluoroscopy cryo-ablation using a 3D electro-anatomical system (3DS) has been used for AVNRT in children. We aimed to facilitate a fluoroscopy limited approach of RF ablation of AVNRT in children.

Methods: A retrospective study was performed of procedure parameters in children undergoing RF ablation of AVNRT in 75 consecutive children (June 2011 to November 2013 - Group A) using standard fluoroscopy techniques compared to those of 64 consecutive children (December 2013 to May 2015 - Group B), using a fluoroscopy limited approach with 3DS. Read More