BACKGROUND We correlated the electrophysiologic (EP) effects of adenosine with tachycardia mechanisms in patients with supraventricular tachycardias (SVT). METHODS AND RESULTS Adenosine was administered to 229 patients with SVTs during EP study: atrioventricular (AV) reentry (AVRT; n=59), typical atrioventricular node reentry (AVNRT; n=82), atypical AVNRT (n=13), permanent junctional reciproc...

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...

Introduction Ablation failure is uncommon for typical slow–fast AV nodal reentrant tachycardia (AVNRT) and it is estimated that in o1% of cases, ablation in the left atrium is required to modify the circuit. We report a case of typical AVNRT refractory to medical therapy and standard ablation approaches, that ultimately required ablation from the left ventricle to achieve noninducibility and cl...

Typical atrioventricular (AV) nodal reentry tachycardia (AVNRT) is characterized by anterograde activation over a slowly conducting pathway and by retrograde activation through a rapidly conducting pathway. Preliminary reports suggest that radiofrequency catheter modification can eliminate typical AVNRT while preserving anterograde conduction. Radiofrequency catheter modification was used to tr...

BACKGROUND The utility of transcatheter application of radiofrequency energy to eliminate atrioventricular nodal reentrant tachycardia (AVNRT) was investigated. METHODS AND RESULTS Thirty-nine patients (mean age, 53 +/- 20 years; range 14-86 years) with medically refractory AVNRT underwent perinodal ablation with radiofrequency energy. A custom-designed 6F catheter with a large (3-mm-long) di...

Atrioventricular nodal reentrant tachycardia (AVNRT) represents the most common regular supraventricular arrhythmia in humans.1 The precise anatomic site and nature of the pathways involved have not yet been established, and several attempts to provide a reasonable hypothesis based on anatomic or anisotropic models have been made.2 There has been considerable evidence that the right and left in...

BACKGROUND When performing catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT), it can be difficult to maintain a safe distance from the His recording site to avoid AV block in patients with a short distance between this recording site to the coronary sinus (CS) ostium (small triangle of Koch [TOK]). In this study, we sought to identify parameters predicting small TOK and ...

We read the article by Okumura et al. [1] with great interest. The authors reported an ablation strategy applying manifest entrainment to treat adenosine triphosphate (ATP)-sensitive atrial tachycardia (AT) originating from the perinodal region. However, we have some concerns regarding the electrophysiological diagnosis of the tachycardia. The exclusion of atrioventricular nodal reentrant tachy...

OBJECTIVE To evaluate the efficacy of single dose intravenous adenosine in differentiating atrioventricular nodal re-entrant tachycardia (AVNRT) from concealed pathway mediated atrioventricular re-entrant tachycardia (AVRT) using surface ECG at the bedside. METHOD 12 mg of adenosine was administered to 97 consecutive patients who had documented narrow QRS tachycardia without manifest pre-exci...

BACKGROUND Transvenous catheter ablation of atrioventricular nodal re-entrant tachycardia (AVNRT) with radiofrequency (RF) is effective and safe, but carries a 1-3% incidence of early and potentially late heart block. Cryothermy can create transient effects, and identify potentially successful ablation sites and decrease the risk for permanent heart block. METHODS In this prospective, randomi...