Histological Examination of the Topography of the Atrioventricular Nodal Artery within the Triangle of Koch

Kozłowski, Dariusz; Koźluk, Edward; Adamowicz, Monika; Grzybiak, Marek; Walczak, Franciszek; Walczak, Ewa

doi:10.1111/j.1540-8159.1998.tb01081.x

Cited by 14 publications

(6 citation statements)

References 14 publications

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“…Proximity to these structures may increase the risk of producing block during ablation around, or inside, the ori ce of the coronary sinus, not only for patients with AV nodal reentry tachycardia, but also for those with accessory pathways located in the inferior pyramidal space. Similar relations between the ori ce of the coronary sinus and the nodal artery were observed by Kozluk et al, 1 2 who found arrangements that were potentially at risk in 8% of their 54 patients studied using coronary angiography, and were reported in 20% of the 50 hearts analyzed histologically by Kozlowski et al 9 Despite this, the induction of AV block is rare. This is possibly due to the cooling effect of the normal blood ow together with the brous adventitia that protects the arteries in these regions.…”

Section: Radiofrequency Catheter Ablation and Injury Of The Nodal Arterysupporting

confidence: 70%

Topographic Anatomy of the Inferior Pyramidal Space: Relevance to Radiofrequency Catheter Ablation

Sánchez‐Quintana

Cabrera

et al. 2001

Cardiovasc electrophysiol

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Section: Radiofrequency Catheter Ablation and Injury Of The Nodal Arterysupporting

confidence: 70%

Topographic Anatomy of the Inferior Pyramidal Space: Relevance to Radiofrequency Catheter Ablation

Sánchez‐Quintana

Cabrera

et al. 2001

Cardiovasc electrophysiol

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“…, , ). This anatomy implies a possible risk of injuring the atrioventricular nodal artery during slow pathway modification (Dean et al, ; Kozlowski et al, ).…”

Section: Three‐dimensional Image Of the Inferior Pyramidal Spacementioning

confidence: 99%

Clinical structural anatomy of the inferior pyramidal space reconstructed from the living heart: Three‐dimensional visualization using multidetector‐row computed tomography

et al. 2014

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The inferior pyramidal space (IPS) comprises the epicardial visceral adipose tissue wedged between the bottoms of the four cardiac chambers from the postero-inferior epicardial surface of the heart. Understanding the complex anatomy around the IPS is important for clinical cardiologists. Although leading anatomists and radiologists have clarified the anatomy of the IPS in detail, few studies have demonstrated this anatomy in three dimensions. The aim of this study was to visualize the three-dimensional anatomy of the IPS reconstructed from the living heart using multidetector-row computed tomography. We also developed an original paper model of the IPS to enhance understanding of its intricate structure.

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“…In this group of patients, the terms tachycardia-induced ST-segment depression, myocardial subendocardial ischemia, recording artifact, and other ill-defined terms are used to explain these ECG changes. [ 3 – 5 ] These ST segment alterations may occur in the presence of various types of artifacts that overlap with the individual components of the QRS complex, which alter the baseline and imitate the typical electrocardiographic changes seen in myocardial ischemia. [ 6 ] An example of such changes is atrial flutter in the inferior leads, in which the flutter wave can imitate pathological q waves and resemble a previous myocardial infarction, but may also affect the ST segment and T waves, mimicking acute ischemic changes.…”

Section: Introductionmentioning

confidence: 99%

ST-segment depression in atrioventricular nodal reentrant tachycardia: Important finding or just an artifact?

et al. 2022

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Background: The ST segment is component of the QRS-T complex located between the QRS and the T wave. ST segment changes during tachycardia with narrow QRS mainly takes the form of ST segment depression. This phenomenon is often observed in young healthy people for whom an ischemic background is unlikely. Materials and methods: The study included 104 patients (71 women and 33 men) with paroxysmal narrow QRS complex tachycardia. In all patients electrophysiological study was performed and the diagnosis of atrioventricular nodal reentrant tachycardia was established. The arrhythmogenic substrate was then eliminated successfully by subsequent ablation using radiofrequency energy which confirmed the diagnosis, all patients had measured QRS components – QR, RS and RJ during the tachycardia and during the sinusrhythm. All of the measurements were done in lead V5. Results: The difference RJ-QR during tachycardia and sinus rhythm correlated negatively with tachycardia cycle length (R = 0.356, P = .001), first slowly, then rapidly reaching the cycle value of about 300 ms, then it decreases, stabilizing at the cycle level of about 270. By separating the RJ-QR in tachycardia and in the sinus rhythm from the tachycardia cycle, we can see that the correlation described in this point is largely due to the correlation between the heart rate and RJ-QR length in tachycardia. Conclusions: In patients with atrioventricular nodal reentrant tachycardia, there is a significant ST-segment depression during tachycardia episodes and the degree of this change is related to tachycardia cycle length. The most probable explanation of the ST-segment depression is the overlap of the QRS complex on the preceded T wave. This phenomenon is also influenced by some intrinsic properties of the individual electrocardiogram. It is possible to rule out ischemic origin of the presented ST segment change.

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Histological Examination of the Topography of the Atrioventricular Nodal Artery within the Triangle of Koch

Abstract: 1) in 20% of examined hearts the AVN artery lay just beneath the endocardium near the coronary sinus ostium 2) there is a risk of the AVN artery coagulation during radiofrequency ablation in the slow pathway region.

Cited by 14 publications

References 14 publications

Topographic Anatomy of the Inferior Pyramidal Space: Relevance to Radiofrequency Catheter Ablation

Topographic Anatomy of the Inferior Pyramidal Space: Relevance to Radiofrequency Catheter Ablation

Clinical structural anatomy of the inferior pyramidal space reconstructed from the living heart: Three‐dimensional visualization using multidetector‐row computed tomography

ST-segment depression in atrioventricular nodal reentrant tachycardia: Important finding or just an artifact?

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