Ablation of Atrioventricular Junctional Tachycardias

González, Mario D.; Banchs, Javier E.; Moukabary, Talal; Rivera, Jaime A.

doi:10.1016/b978-0-323-52992-1.00021-1

Cited by 4 publications

(17 citation statements)

References 138 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lower powers, between 25 W and 40 W, have been used with 4-mm-tip nonirrigated radiofrequency ablation catheters. 3 , 57 Some operators have described no further need for left atrial ablation after adopting ablation within the coronary sinus using externally irrigated radiofrequency catheters to deliver energy between 10 W and 20 W. 3 …”

Section: Discussionmentioning

confidence: 99%

“…A 3-part stepwise anatomic approach to right-sided slow pathway ablation has been described by Gonzalez and colleagues. 3 The first site, targeting the right inferior input of the AV node, is “between [the coronary sinus] ostium and tricuspid annulus at the level of [the coronary sinus] ostium.” The second site, targeting the left inferior input of the AV node, is the proximal (up to 20 mm inside) coronary sinus musculature at the roof. The third site is within the triangle of Koch, superior to the coronary sinus ostium.…”

Section: Discussionmentioning

confidence: 99%

“…Conventional ablation for AVNRT consists of 2 approaches guided primarily by anatomy or electrograms. 3 In practice, these approaches are often combined. 9 Pooling the experience of the reviewed articles, a general technique can be proposed.…”

Section: Discussionmentioning

confidence: 99%

“…Catheter ablation is the treatment of choice for curative care of atrioventricular nodal reentrant tachycardia (AVNRT). 1 , 2 , 3 It is one of the greatest triumphs of the early invasive clinical cardiac electrophysiology era. 4 Current indications include intractable symptoms refractory to medical management, patient preference, and high-risk occupations.…”

Section: Introductionmentioning

confidence: 99%

“…Rarely, treatment of AVNRT may necessitate catheter ablation within the left atrium. 2 , 3 In a contemporary study from 8 tertiary care centers, this was required in 11 of 1084 (1.0%) patients. 9 The purpose of this narrative review is to provide a comprehensive overview of catheter ablation via the left atrium for AVNRT.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

Wang

2021

Heart Rhythm O2

View full text Add to dashboard Cite

Background Since 1996, it has been recognized that catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) may require an approach through the left atrium. Objective The purposes are to present a case report and to provide a comprehensive narrative review on this topic. Methods A literature review of all articles that provided detailed information on patients who underwent catheter ablation via the left atrium for AVNRT was performed. The primary search queried PubMed using Medical Subject Headings (MeSH) terms “atrioventricular nodal reentrant tachycardia” and “left.” The secondary search was performed by manual review of reference lists and Google Scholar citations of manuscripts retrieved by the primary search. The review was limited to the English language. Results The searches yielded 30 articles that described 79 patients. A case report was added. Therefore, the final review consisted of 80 patients. The prevalence of left atrial ablation for patients with AVNRT undergoing catheter ablation at tertiary care centers was approximately 1%. Failed right atrial ablation, with or without coronary sinus ablation, was the most common indication for left atrial ablation. Pooled data from 3 cohort studies estimated the acute success rate for radiofrequency ablation of the slow pathway at the septal or inferoparaseptal segments of the mitral valve annulus after failed right-sided ablation to be 90%. There were no reports of atrioventricular block requiring permanent pacemaker implantation. Conclusion Catheter ablation of the slow pathway via the left atrium is an important technique for AVNRT cases that are refractory to conventional ablation.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

Wang

2021

Heart Rhythm O2

View full text Add to dashboard Cite

show abstract

Feasibility and safety of interventional electrophysiology and catheter ablation in the South African public sector: Challenges and opportunities for comprehensive cardiac electrophysiology in South Africa

Mkoko

Barole

Solomon

et al. 2022

Journal of Arrhythmia

View full text Add to dashboard Cite

Aims The spectrum and outcomes of catheter ablation procedures performed in South Africa are unknown, and therefore, the feasibility of interventional electrophysiology in the South African public sector is undetermined. Methods and Results This study was a retrospective review of all patients that underwent invasive electrophysiology procedures and catheter ablation at Groote Schuur Hospital (GSH) and the University of Cape Town Private Academic Hospital (UCTPAH) between 01 January 2013 and 31 December 2020. One thousand one hundred eighty‐six invasive electrophysiology procedures were performed during the study period. Of these were 1102 catheter ablation procedures. There were 76 redo catheter ablation procedures, predominantly for atrial fibrillation (AF), which accounted for 39% (30/76) of the repeat procedures. There were only 0.8% (9/1102) catheter ablation related complications which were mostly access related. Atrial fibrillation accounted for most of the ablation procedures, 28.9% (318/1102); these were mainly performed at UCTPAH than at GSH, 300 vs 18 p < .0001. Cavotricuspid isthmus (CTI) dependent atrial flutter ablation was the second most commonly performed catheter ablation procedure, accounting for 21.6% (238/1102) of the catheter ablation procedures. More CTI dependent atrial flutter ablations were performed at GSH than a UCTPAH, 156 vs 82 p < .0001. The overall success rate of catheter ablation was 92%. Conclusion A broad spectrum of catheter ablation procedures was performed with a high success rate and limited complications, thus demonstrating the feasibility of safe cardiac electrophysiology and catheter ablation in the South African public sector.

show abstract

Conventional electrode catheter placement can miss crucial atypical atrioventricular nodal reentrant tachycardia circuit details. -New insights into the retrograde slow pathways-

Kawabata,

Maeda,

Okishige

et al. 2024

Preprint

View full text Add to dashboard Cite

BackgroundDuring atypical atrioventricular nodal reentrant tachycardia (AVNRT), the earliest atrial activation site following retrograde slow pathway (SP) conduction is at the atrial exit of the left inferior extension of the compact node (LIE) in the coronary sinus (CS) or the right inferior extension (RIE) on the tricuspid annulus (TA). We tested the validity of conventional electrode placement-based mapping of the atrial ends of these extensions.MethodsWe retrospectively evaluated the efficiency of the two catheter (His bundle and CS) mapping method for localization of LIE and RIE in atypical AVNRT patient using electroanatomical 3D mapping validation.ResultsAmong 19 atypical AVNRTs (15 fast/slow and 4 slow/slow) in 14 patients (9 females, age 59±17), 8 AVNRTs had LIE involvement and 11 had RIE. The 8 LIE exits were inside the CS, and localization by 3D mapping and CS electrode catheter matched in all. In contrast, RIE exits were on the posterior TA where electrode catheters are conventionally not placed. All RIE exits required 3D mapping for accurate localization. During retrograde RIE conduction, comparison of the activation time of the CS ostium and HBE showed that the CS ostium was earlier in 7 RIEs, HBE was earlier in 1, and they were simultaneous in 3, resulting in the presence of RIE being missed in 4/11 (36%) AVNRTs using current diagnostic criteria. Activation time of the CS ostium and His bundle were determined by their relative closeness to the RIE exit.ConclusionsConventionally placed electrode catheter mapping in atypical AVNRT was able to identify 100% of LIE, but only 64% of RIE. It is critical to place a catheter on or use a 3D mapping system for the posterior TA in cases of suspected atypical AVNRT, so that all inferior extensions of the AV node can be identified and targeted for treatment.

show abstract

Ablation of Atrioventricular Junctional Tachycardias

Cited by 4 publications

References 138 publications

Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

Feasibility and safety of interventional electrophysiology and catheter ablation in the South African public sector: Challenges and opportunities for comprehensive cardiac electrophysiology in South Africa

Conventional electrode catheter placement can miss crucial atypical atrioventricular nodal reentrant tachycardia circuit details. -New insights into the retrograde slow pathways-

Contact Info

Product

Resources

About