Electrophysiological properties of the atrioventricular node and ageing: evidence of a lower incidence of dual nodal pathways in the elderly

D’Este, D; Bertaglia, Emanuele; Zanocco, Albino; Reimers, Bernhard; Pascotto, Pietro

doi:10.1053/eupc.2001.0175

Cited by 13 publications

(12 citation statements)

References 22 publications

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“…Indeed, the finding that AVNRT generally occurs in adulthood, the mean age of onset of symptoms being over 30 years [7,8], has prompted many authors to regard it as a developmental disease. Furthermore, some authors have recently demonstrated that the incidence of dual AV node pathways in subjects without AVNRT decreases with ageing [9], and others [10] have reported critical changes in retrograde fast pathway conduction in some patients with AVNRT in whom the tachycardia spontaneously disappeared over time. However, the disappearance of the arrhythmias on ageing has also been described with regard to other forms of supraventricular tachycardias, such as ectopic atrial tachycardia [11] and the supraventricular tachycardias of the Wolff-ParkinsonWhite syndrome [12,13].…”

Section: Discussionmentioning

confidence: 98%

Long-term outcome of patients with atrioventricular node reentrant tachycardia

D’Este

Zoppo

Bertaglia

et al. 2007

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 98%

Long-term outcome of patients with atrioventricular node reentrant tachycardia

D’Este

Zoppo

Bertaglia

et al. 2007

International Journal of Cardiology

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“…The prevalence of dual pathways physiology is variably reported as being demonstrable in 10 to 35% of normal people [25-28] including children [29], but may become less common with aging [30]. A multitude of electrocardiographic manifestations [19,31,32] may be explained by dual pathways physiology (see Table 1).…”

Section: Ecg Manifestations Of Dual Av Nodal Pathways Physiologymentioning

confidence: 99%

“…[17] It can also manifest as two families of PR intervals that signify presence of underlying dual AV nodal physiology. [19,30]…”

Section: Ecg Manifestations Of Dual Av Nodal Pathways Physiologymentioning

confidence: 99%

Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

Mani

Pavri

2014

Indian Pacing and Electrophysiology Journal

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More than half a century has passed since the concept of dual atrioventricular (AV) nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.

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“…Up 37% of subjects have dual AV nodal physiology; however only a minority of these develops nodal reentrant tachycardia. Furthermore, incidence of dual AV nodal pathways decreases with ageing [12].…”

Section: Typical Atrioventricular Nodal Reentrant Tachycardiamentioning

confidence: 99%

Typical atrioventricular nodal reentrant and orthodromic atrioventricular tachycardias: electrocardiographic, electrophysiological diagnosis and treatment

Silva¹,

Roever²

2016

ica

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The narrow QRS tachycardia is that which originates above the His bundle bifurcation, with QRS complexes of less than 120 ms and heart rate of more than 100 beats per minute (bpm). Its prevalence in the general population is 6 to 8/1000 individuals, reaching 11% to 18% in patients with heart failure [1]. Among children the duration of the QRS of the tachycardia is equal to or less than 90 seconds and heart rate can exceed 200 bpm in newborn infants and higher than 100 bpm (from 130 to 300 bpm) in those over 10 years of age [1,2].Among the regular narrow QRS tachycardia, the most common is typical atrioventricular (AV) nodal reentrant tachycardia, followed by orthodromic AV tachycardia. Symptoms include palpitations, fatigue, chest pain, light-headedness, neck discomfort, polyuria and pre-syncope and syncope. Polyuria is due to the natriuretic peptide secreted by the distension of the atria. Syncope can occur between 15% and 20% of patients, due to the high rate of the tachyarrhythmia (≥ 170 bpm). Besides this morbidity, these tachycardias can lead Paroxysmal supraventricular tachycardias with narrow QRS are defined as rhythms originating from above the His bundle, heart rate higher 100 bpm and QRS complex of less than 120 ms in adults or less than 90 ms in children. They present a prevalence of up to 8/1000 individuals. The main presentations of these regular tachycardias are atrioventricular nodal re-entrant tachycardia and orthodromic atrioventricular reentrant tachycardia due to an accessory pathway. These tachycardias present morbidity, with symptoms such as palpitations, dyspnea, chest pain, syncope, polyuria, and can be a cause of sudden cardiac death. Thus, their clinical and electrocardiographic diagnoses are the first step in the approach and treatment of the patient. This review will discuss the clinical aspects, electrocardiographic, electrophysiological diagnosis and treatment options in the acute phase and long-term management, in addition to nonpharmacological treatment.

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Electrophysiological properties of the atrioventricular node and ageing: evidence of a lower incidence of dual nodal pathways in the elderly

Abstract: The incidence of dual AV nodal pathways decreases with ageing, suggesting that the AV node undergoes age-related electrophysiological changes. This finding could explain the uncommon onset of AV nodal re-entrant tachycardia in the elderly.

Cited by 13 publications

References 22 publications

Long-term outcome of patients with atrioventricular node reentrant tachycardia

Long-term outcome of patients with atrioventricular node reentrant tachycardia

Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

Typical atrioventricular nodal reentrant and orthodromic atrioventricular tachycardias: electrocardiographic, electrophysiological diagnosis and treatment

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