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'Atrioventricular Nodal Reentry Tachycardia AVNRT' (714)


Feb
2018

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.

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Feb
2018

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.

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Jan
2018

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.

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Dec
2017

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.

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Jan
2018

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.

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Feb
2018

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.
This review evaluates the literature and controversies concerning treatment of AVNRT in the ED.

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Jan
2018

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.
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.

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Nov
2017

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).
We screened 149 symptomatic patients who underwent ESPM in our department between 1993 and 2013.

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Nov
2017

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.
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).
A total of 18 patients with symptomatic typical AVNRT referred for ablation underwent ultrahigh-density mapping of atrial activation with minielectrode basket configuration during tachycardia.

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Aug
2017

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.

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Aug
2017

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.

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Jan
2018

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).

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Nov
2017

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.
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.

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Jun
2017

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).

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Aug
2017

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.

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May
2017

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.

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Apr
2017

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

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Apr
2017

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.
From June 2015 to May 2016, 35 consecutive paediatric patients (mean age 12.

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Feb
2017

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.

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Jun
2017

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.
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.

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Mar
2017

If a transfemoral approach for catheter ablation procedures of paroxysmal supraventricular tachycardias is impossible, other access sites have to be considered. We present the case of a 78-year-old woman with an inferior vena cava (IVC) filter with symptomatic episodes of an atrioventricular nodal reentrant tachycardia (AVNRT). We used a combined cubital and axillary vein approach.

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Dec
1969

Clinical studies in humans have shown the site of atrial stimulation to influence atrioventricular (AV) conduction times and refractory periods, the demonstration of dual AV nodal (AVN) pathways, and induction of AVN reentry. These studies often found conflicting results. Moreover, among enrolled patients a minority of them were found to have AVN reentrant tachycardia (AVNRT).

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Apr
2017

Catheter ablation of the slow pathway is the most effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). Cryoenergy, compared to radiofrequency, relates to lower heart block risk but higher incidence of AVNRT recurrences. The aims of this study are to confirm the safety and efficacy of AVNRT cryoablation and to identify predictors of long-term recurrences.

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Dec
1969

Data regarding long-term follow-up of radiofrequency catheter ablation (RFCA) of accessory pathways (APs) in patients with Ebstein's anomaly (EA) are limited. The procedures are challenging due to multiple or wide APs.
Analysis was performed on clinical and periprocedural data of patients with EA referred to the centre in order to perform catheter ablation of AP.

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Nov
2016

Catheter ablation of the slow conducting pathway (SP) is treatment of choice for atrioventricular nodal reentrant tachycardia (AVNRT). Although there are abundant data on AVNRT ablation in adult patients, little is known about the long-term results ≥3 years after AVNRT ablation in pediatric patients.
Follow-up data from 241 patients aged ≤18 years who had undergone successful AVNRT ablation were analyzed.

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Dec
2016

A proposed model consisting of two coupled models (Hodgkin-Huxley and Yanagihara-Noma-Irisawa model) is considered as a description of the heart's action potential. System of ordinary differential equations is used to recreate pathological behaviour in the conducting heart's system such as double fire and the most common tachycardia: atrioventricular nodal reentrant tachycardia (AVNRT). Part of the population has an abnormal accessory pathways: fast and slow (Fujiki, 2008).

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Nov
2016

Transcatheter cryoablation is a well-established technique for the treatment of atrioventricular nodal reentry tachycardia (AVNRT) in children. Nevertheless, atrioventricular nodal slow-pathway conduction may recur after an acutely successful procedure. The aim of this study was to evaluate the long-term outcome of acutely successful AVNRT cryoablations in pediatric patients in case of focal cryolesion and in case of need for High-Density Linear Lesion (HDLL) cryoablation due to focal failure.

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Nov
2016

Because of its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method has not been established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT.
We studied 2079 patients with AVNRT subjected to slow pathway ablation.

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Jul
2016

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of paroxysmal supraventricular tachycardia (SVT) whose diagnosis can be strongly suspected based on the surface eletrocardiogram alone. The purpose of this study is to determine the diagnostic accuracy of several electrocardiographic (ECG) criteria for the prediction of AVNRT.
Between November 2010 and January 2014, a total of 256 patients who underwent electrophysiological testing (EP) with regular, paroxysmal and narrow QRS complex tachycardia were prospectively enrolled.

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Nov
2016

There are limited adult data suggesting the tachycardia cycle length (TCL) of atrioventricular reentry tachycardia (AVRT) is shorter than atrioventricular nodal reentry tachycardia (AVNRT), though little data exist in children. We sought to determine if there is a difference in TCL between AVRT and AVNRT in children.
A single-center retrospective review of children with supraventricular tachycardia (SVT) from 2000 to 2015 was performed.

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Dec
2016

Differentiating between atrioventricular nodal reentrant tachycardia (AVNRT) and non-reentrant junctional tachycardia (JT) is difficult but highly necessary for catheter ablation. The purpose of this study was to investigate whether the ventriculoatrial (VA) relationship after atrial overdrive pacing (AOP) could help to distinguish AVNRT from JT.
Thirty-eight AVNRT and 21 JT patients who were induced by infusion of isoproterenol after successful AVNRT ablation were paced through the high right atrium or coronary sinus until the ventricles were constantly captured.

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Mar
2017

The exact circuit responsible for the atrioventricular (AV) nodal reentrant tachycardia (AVNRT) is still unknown. We evaluated the optimal slow pathway ablation area in patients with and without 2:1 AV conduction during the slow-fast AVNRT.
Among 207 consecutive patients with slow-fast AVNRT who underwent slow pathway ablation, 12 (5.

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Jul
2016

Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also rare.

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Dec
2016

"2 for 1 phenomenon" is simultaneous anterograde conduction over the fast and slow pathways of the atrioventricular (AV) nodal pathway, leading to a double ventricular response from each atrial beat. This phenomenon can initiate AV nodal reentrant tachycardia (AVNRT). The unique induction of AVNRT was observed in a patient with an implantable cardioverter defibrillator in our case.

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Oct
2016

Cryothermal ablation (CTA) for atrioventricular nodal reentrant tachycardia (AVNRT) is considered safer than radiofrequency ablation (RFA) since it eliminates the risk of inadvertent AV block. However, it has not been widely adopted due to high late recurrence rate (LRR). In an effort to improve LRR, we evaluated a new approach to cryothermal mapping (CTM): "time to tachycardia termination" (TTT).

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Aug
2016

Postpacing interval (PPI) measured after entrainment pacing describes the distance between pacing site and reentrant circuit. However, the influential features to PPI remain to be elucidated.
This study included 22 cases with slow/fast atrioventricular (AV) nodal reentrant tachycardia (AVNRT), 14 orthodromic AV reciprocating tachycardia (AVRT) using an accessary pathway, 22 typical atrial flutter (AFL), and 18 other macroreentrant atrial tachycardia (atypical AFL).

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Dec
1969

Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown.
Out of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs.

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Mar
2016

Narrow Complex Tachycardia: What is the Mechanism?

Card Electrophysiol Clin 2016 Mar 13;8(1):67-9. Epub 2016 Jan 13.
Marwan M Refaat, Melvin Scheinman, Nitish Badhwar
This article presents a diagnostic dilemma in which atrioventricular nodal reentrant tachycardia (AVNRT) and junctional tachycardia (JT) were differentiated based on tachycardia initiation with atrial extrastimulus as well as on the response to progressive decremental atrial extrastimuli. The progressive increase in A2H2' and H2H2' in response to atrial extrastimuli favors reentry as the mechanism of the tachycardia. This is a novel mechanistic differentiation of AVNRT from focal JT.

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Mar
2016

Incessant Palpitations and Narrow Complex Tachycardia.

Card Electrophysiol Clin 2016 Mar 8;8(1):61-5. Epub 2016 Jan 8.
Frederick T Han
Junctional tachycardia (JT) is rare cause of supraventricular tachycardia. The intracardiac activation sequence is similar to atrioventricular nodal reentrant tachycardia (AVNRT). Premature atrial contractions inserted during tachycardia can help distinguish JT from AVNRT.

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Mar
2016

This report illustrates an interesting case of atrioventricular nodal reentrant tachycardia that presented with 2 different ventricular cycle lengths due to a 2:1 block in the lower common pathway. At the induction of the tachycardia, a long-short sequence above the His creates a phase 3 block resulting in a 2:1 conduction in the lower common pathway. A premature ventricular contraction, by retrograde penetration of the His, eliminates the long-short sequence and brings the conduction back to 1:1.

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Jul
2016

The use of non-fluoroscopic systems (NFS) to guide radiofrequency catheter ablation (RFCA) for the treatment of supraventricular tachycardia (SVT) is associated with lower radiation exposure. This study aimed to determine if NFS reduces fluoroscopy time, radiation dose and procedure time.
We prospectively enrolled patients undergoing RFCA for SVT.

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Dec
1969

Variability in atrioventricular (AV) node location in congenital heart disease (CHD) can make catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) challenging.
The purpose of this study was to describe institutional technique and outcomes for slow pathway modification in a cohort with CHD.
The study consisted of a retrospective review of CHD patients who underwent study from 2001 to 2013 with a diagnosis of AVNRT.

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Dec
1969

We report a three-generation family coming from southeastern region of Poland (Podkarpackie voivodship) with 6 women having normal hearts and presenting with a history of paroxysmal tachycardia with onset of symptoms in the adulthood. Recordings of clinical SVT, dual AVN electrophysiology, induction of typical AVNRT and results of RFCA are available. The history of this family shows the significance of a careful and detailed collection of medical history, and point towards the importance of family screening in AVNRT patients.

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Dec
2015

To establish an appropriate treatment strategy and determine if ablation is indicated for patients with narrow QRS complex supraventricular tachycardia (SVT), analysis of a standard 12-lead electrocardiogram (ECG) is required, which can differentiate between the 2 most common mechanisms underlying SVT: atrioventricular nodal reentry tachycardia (AVNRT) and orthodromic atrioventricular reentry tachycardia (OAVRT). Recently, new, highly accurate electrocardiographic criteria for the differential diagnosis of SVT in adults were proposed; however, those criteria have not yet been validated in a pediatric population.All ECGs were recorded during invasive electrophysiology study of pediatric patients (n = 212; age: 13.

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Dec
2015

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common form of supraventricular tachycardia. In contrast, Wolff-Parkinson-White (WPW) pattern consists of an accessory pathway, which may result in the development of ventricular arrhythmias. Frequent tachycardia caused by AVNRT and accessory pathways may play a role in left ventricular systolic dysfunction.

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Mar
2016

This study aimed to clarify whether retrograde P-wave amplitude during tachycardia can be used to differentiate slow-slow form of atrioventricular nodal reentrant tachycardia (S/S-AVNRT) from atrioventricular reentrant tachycardia through a posteroseptal accessory pathway (PS-AVRT).
Sixteen patients with S/S-AVNRT and 14 patients with PS-AVRT constituted the study group. Electrocardiographic and electrophysiological parameters were compared between both the groups.

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Aug
2016

The detailed electrophysiological characteristics of patients with both atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial flutter (AFL) have not been clarified. This study investigated the related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation of AVNRT.
A total of 1063 clinically documented AVNRT patients underwent catheter ablation were enrolled.

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Dec
2015

The AV nodal reentrant tachycardia (AVNRT) is one of the most common arrhythmias encountered in clinical practice. It is characterized by a constant heart rate and an on/off phenomenon. The clinical symptoms may include palpitations, anxiety, polyuria, and dyspnea.

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Jan
2016

The existence of an atypical fast-slow (F/S) atrioventricular nodal reentrant tachycardia (AVNRT) including a superior (sup) pathway with slow conductive properties and an atrial exit near the His bundle has not been confirmed.
We studied 6 women and 2 men (age, 74 ± 7 years) with sup-F/S-AVNRT who underwent successful radiofrequency ablation near the His bundle. Programmed ventricular stimulation induced retrograde conduction over a superior SP with an earliest atrial activation near the His bundle, a mean shortest spike-atrial interval of 378 ± 119 milliseconds, and decremental properties in all patients.

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Feb
2016

Postpacing interval (PPI) after right ventricular (RV) pacing entrainment minus tachycardia cycle length (TCL) with a correction for atrioventricular (AV) node delay (corrected PPI-TCL) was useful to differentiate atrioventricular node reentrant tachycardia (AVNRT) from orthodromic reciprocating tachycardia (ORT). However, the value of corrected PPI-TCL in determining the site of the accessory pathway (AP) in ORT has not been investigated. The purpose of this study was to assess whether the corrected PPI-TCL is useful in differentiating ORT using a left-sided AP from a right-sided AP.

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