A case of typical and atypical atrioventricular nodal reentrant tachycardia with a bystander nodoventricular pathway diagnosed based on the findings during early ventricular premature contractions

Sekihara, Takayuki; Nakano, Tomoaki; Yasuoka, Yoshinori; Minamiguchi, Hitoshi

doi:10.1016/j.hrcr.2020.06.016

Cited by 5 publications

(11 citation statements)

References 10 publications

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“…The same phenomenon can be observed in SP/FP typical AVNRT with bystander concealed NV/NF pathway. Sekihara and colleagues 13 reported reset phenomenon with delay after His-refractory VES in patients with typical SP/FP AVNRT with bystander concealed NV/NF pathway, just as in SVT-2b of the present case.…”

Section: Discussionsupporting

confidence: 67%

A case of preexcitation syndrome showing atypical atrioventricular nodal reentrant tachycardia and orthodromic atrioventricular reciprocating tachycardia with a bystander concealed nodoventricular/nodofascicular pathway

Nishiwaki

Shizuta

Tanaka

et al. 2022

HeartRhythm Case Reports

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Section: Discussionsupporting

confidence: 67%

A case of preexcitation syndrome showing atypical atrioventricular nodal reentrant tachycardia and orthodromic atrioventricular reciprocating tachycardia with a bystander concealed nodoventricular/nodofascicular pathway

Nishiwaki

Shizuta

Tanaka

et al. 2022

HeartRhythm Case Reports

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“…The first step was identification of the presence of a concealed atrioventricular AP or cNVP. The presence of either AP, except the NFP, was recognized on observation of tachycardia reset without any change in the atrial sequence and/or termination without atrial capture upon His‐refractory PVC that exhibited a fused QRS morphology 2,4–9 . In our study, presence of either AP was recognized in 14 of the 17 AVNRTs.…”

Section: Resultssupporting

confidence: 52%

“…Differentiation of orthodromic reciprocating tachycardia (ORT) incorporating a concealed nodoventricular pathway (cNVP) from atrioventricular nodal reentrant tachycardia (AVNRT) is particularly challenging and requires careful interpretation of the intracardiac electrograms 1–3 . Furthermore, differential diagnosis is not necessarily exclusive of ORT or AVNRT; there are several reports of AVNRT with a bystander cNVP 1–9 . However, criteria have not yet been developed for systematic diagnosis of AVNRT with a bystander cNVP because of the difficulty in differentiating this arrhythmia from NV‐ORT, and this lack leads to underdiagnosis.…”

Section: Introductionmentioning

confidence: 99%

Systematic observation‐based diagnosis of atrioventricular nodal reentrant tachycardia with a bystander concealed nodoventricular pathway

Nagashima,

Maruyama,

Kaneko

et al. 2023

Journal of Arrhythmia

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BackgroundThis study aimed to establish a systematic method for diagnosing atrioventricular nodal reentrant tachycardia (AVNRT) with a bystander concealed nodoventricular pathway (cNVP).MethodsWe analyzed 13 cases of AVNRT with a bystander cNVP, 11 connected to the slow pathway (cNVP‐SP) and two to the fast pathway (cNVP‐FP), along with two cases of cNVP‐related orthodromic reciprocating tachycardia (ORT).ResultsThe diagnostic process was summarized in three steps. Step 1 was identification of the presence of an accessory pathway by resetting the tachycardia with delay (n = 9) and termination without atrial capture (n = 4) immediately after delivery of a His‐refractory premature ventricular contraction (PVC). Step 2 was exclusion of ORT by atrio‐His block during the tachycardia (n = 4), disappearance of the reset phenomenon after the early PVC (n = 7), or dissociation of His from the tachycardia during ventricular overdrive pacing (n = 1). Moreover, tachycardia reset/termination without the atrial capture (n = 2/2) 1 cycle after the His‐refractory PVC was specifically diagnostic. Exceptionally, the disappearance of the reset phenomenon was also observed in the two cNVP‐ORTs. Step 3 was verification of the AVN as the cNVP insertion site, evidenced by an atrial reset/block preceding the His reset/block in fast–slow AVNRT with a cNVP‐SP and slow–fast AVNRT with a cNVP‐FP or His reset preceding the atrial reset in slow–fast AVNRT with a cNVP‐SP.ConclusionAVNRT with a bystander cNVP can be diagnosed in the three steps with few exceptions. Notably, tachycardia reset/termination without atrial capture one cycle after delivery of a His‐refractory PVC is specifically diagnostic.

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“…The observation of His-refractory VPD repeatedly terminating the tachycardia without conducting to the atrium excluded atrial tachycardia and AP-independent tachycardia. 3 …”

Section: Discussionmentioning

confidence: 99%

“…Discussion: The observation of His refractory VPD repeatedly terminating the tachycardia without conducting to the atrium excluded atrial tachycardia and accessory pathway independent tachycardia. 3 However, during ventricular overdrive pacing (VOP), atrial cycle length continued at tachycardia cycle length even though the ventricle was captured at a different cycle length (with local VA interval change) during progressive fusion (Figure 2A). How to account for different cycle lengths of ventricle and atrium during VOP?…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Incessant supraventricular tachycardia following tricuspid valve repair: Unmasking of a nodoventricular pathway

Sriramoju¹,

Srivathsan²,

Shen³

2022

HeartRhythm Case Reports

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show abstract

A case of typical and atypical atrioventricular nodal reentrant tachycardia with a bystander nodoventricular pathway diagnosed based on the findings during early ventricular premature contractions

Cited by 5 publications

References 10 publications

A case of preexcitation syndrome showing atypical atrioventricular nodal reentrant tachycardia and orthodromic atrioventricular reciprocating tachycardia with a bystander concealed nodoventricular/nodofascicular pathway

A case of preexcitation syndrome showing atypical atrioventricular nodal reentrant tachycardia and orthodromic atrioventricular reciprocating tachycardia with a bystander concealed nodoventricular/nodofascicular pathway

Systematic observation‐based diagnosis of atrioventricular nodal reentrant tachycardia with a bystander concealed nodoventricular pathway

Incessant supraventricular tachycardia following tricuspid valve repair: Unmasking of a nodoventricular pathway

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