OBJECTIVE The aim of this retrospective study was to investigate the association of atrioventricular nodal reentrant tachycardia (AVNRT) with other forms of arrhythmia in individual patients and its consequences for treatment. SUBJECTS AND METHODS This study comprised 493 consecutive patients aged 16-88 years (296 women and 197 men) who were diagnosed with a form of AVNRT via a standard 4-cat...

In more than 95% of patients with atrioventricular nodal reentrant tachycardia (AVNRT), curative treatment can be achieved with selective ablation of the slow pathway in the right-sided septum. We report a patient with typical AVNRT who had failed attempts to perform conventional right septal ablation of the slow as well as of the fast pathway and finally underwent successful ablation of the fa...

INTRODUCTION Reentrant tachyarrhythmias are thought to involve spiral waves of excitation and recovery that may be nonstationary. The effect of muscle fiber curvature on spiral and planar wave propagation was studied using a computational model. METHODS AND RESULTS Two-dimensional anisotropic cardiac propagation was modeled using a finite element method to solve a modification of the FitzHugh...

We describe a patient with an implanted pacemaker for impaired AV conduction who presented with an incessant tachycardia. EP study showed that the tachycardia was atrioventricular nodal reentrant tachycardia (AVNRT) with repeated spontaneous initiation because of poor or absent antegrade fast pathway conduction. Slow pathway ablation was successful in terminating the tachycardia and making it n...

We describe how Art Winfree's ideas about phase singularities can be used to understand the response of cardiac tissue with a random preexisting pattern of reentrant waves (fibrillation) to a large brief current stimulus. This discussion is organized around spatial dimension, beginning with a discussion of reentry on a periodic ring, followed by reentry in a two-dimensional planar domain (spira...

A dual-pathway theory to explain atrioventricular-nodal (AVN) reentry has been proposed previously. However, the exact anatomical and functional correlates of the fast pathway (FP) and slow pathway (SP) have not yet been elucidated. We used optical mapping to reconstruct patterns of activation during retrograde conduction through the AVN and during AVN reentry in the triangles of Koch of 12 rab...

The influence of activation sequences on action potential configuration, especially in the repolarization phase, was examined in isolated canine ventricular muscles. Action potentials were recorded from the epicardial surface in the center of a preparation having nearly uniform fiber orientation (25 X 25 mm). Stimuli applied just adjacent to the recording site produced nearly centrifugal propag...

Inducible atrioventricular nodal reentrant tachycardia was demonstrated by electrophysiological studies in a 55-year-old female who suffered from intermittent palpitation, in which paroxysmal atrial fibrillation (AF) was consistently documented by electrocardiogram recordings. After ablation of the slow pathway, the atrioventricular nodal reentrant tachycardia and AF were not inducible. During ...

We have developed a microcomputer algorithm for tachycardia identification suitable for use in an implanted antitachycardia pacemaker. The algorithm distinguishes atrial, ventricular, and AV reentrant tachycardia, while ignoring high rates due to sinus tachycardia. A new method whereby the pacemaker delivers an atrial extrastimulus has been developed for distinguishing paroxysmal 1:1 tachycardi...

BACKGROUND The reentry circuit of atrioventricular nodal reentrant tachycardia (AVNRT) has not been fully demonstrated. We hypothesized that if an upper common pathway was present, the atrial electrogram could not be captured orthodromically during transient entrainment of AVNRT by rapid atrial pacing. Based on this hypothesis, the presence of an upper common pathway was investigated. METHODS...