Incidence and Mechanism of Dislocated Fast Pathway in Various Forms of Atrioventricular Nodal Reentrant Tachycardia

Tanaka, Yasuaki; Yamabe, Hiroshige; Morihisa, Kenji; Uemura, Takashi; Kawano, Hiroaki; Nagayoshi, Yasuhiro; Kojima, Sunao; Ogawa, Hisao

doi:10.1253/circj.71.1099

Cited by 5 publications

(5 citation statements)

References 21 publications

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“…An inferiorly dislocated AFp (IDF) was recognized in 41% (18/44) of the patients. The incidence of an IDF in this study was much higher than that reported by Delise et al (10%) [2], but was similar to that reported in the other Japanese studies (33-56%) [3,4]. These differences might be related to the ethnic differences and therefore, further studies will be needed.…”

Section: Right Antegrade Fast Pathway Input To the Atrioventricular Nodesupporting

confidence: 83%

“…In the previous studies, the St-H map was the standard map used for the determination of the AFpI [1][2][3][4][5]. In this study, an St-V map was used instead of the St-H map because a His catheter was not used in the majority of the patients who had atrial fibrillation (77%) and the St-V map was equivalent to the St-H map.…”

Section: St-v Map As An Alternative To An St-h Mapmentioning

confidence: 99%

“…The exit site of the retrograde fast pathway (RFp) from the atrioventricular node (AVN) can be determined by mapping the earliest activation site in the atrium during constant pacing from the ventricle. On the other hand, the input site of the antegrade fast pathway (AFp) to the AVN has been very difficult to determine and only stimulus-His (St-H) mapping can identify the input site of the AFp to the AVN (AFpI) [1][2][3][4][5]. The use of a three-dimensional (3-D) mapping system makes identification of the exact location of the AFpI easier to determine [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the input site and characteristics of the antegrade fast pathway based on three-dimensional bi-atrial stimulus-ventricle mapping

Matsumoto

Tobiume

Matsuura

et al. 2021

J Interv Card Electrophysiol

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Purpose Previous studies examined the right atrial (RA) input site of the antegrade fast pathway (AFp) (AFpI). However, the left atrial (LA) input to the atrioventricular (AV) node has not been extensively evaluated. In this study, we created three-dimensional (3-D) bi-atrial stimulus-ventricle (St-V) maps and analyzed the input site and characteristics of the AFp in both the RA and LA. Methods Forty-four patients diagnosed with atrial fibrillation or WPW syndrome were included in this study. Three-dimensional bi-atrial St-V mapping was performed using an electroanatomical mapping system. Sites exhibiting the minimal St-V interval (MinSt-V) were defined as AFpIs and were classified into seven segments, four in the RA (F, S, M, and I) and three in the LA (M1, M2, and M3). By combining the MinSt-V in the RA and LA, the AFpIs were classified into three types: RA, LA, and bi-atrial (BA) types. The clinical and electrophysiological characteristics were compared. Results AFpIs were most frequently observed at site S in the RA (34%) and M2 in the LA (50%), and the BA type was the most common (57%). AFpIs in the LA were recognized in 75% of the patients. There were no clinical or electrophysiological indicators for predicting AFpI sites. Conclusions Three-dimensional bi-atrial St-V maps could classify AFpIs in both the RA and LA. AFpIs in the LA were frequently recognized. There were no significant clinical or electrophysiological indicators for predicting AFpI sites, and 3-D bi-atrial St-V mapping was the only method to reveal the precise AFp input site.

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Section: Right Antegrade Fast Pathway Input To the Atrioventricular Nodesupporting

confidence: 83%

Section: St-v Map As An Alternative To An St-h Mapmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the input site and characteristics of the antegrade fast pathway based on three-dimensional bi-atrial stimulus-ventricle mapping

Matsumoto

Tobiume

Matsuura

et al. 2021

J Interv Card Electrophysiol

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“…Another explanation for AV block involves direct damage to a dislocated A‐FP. Previous studies have reported that dislocated A‐FPs, which are located more than 10 mm inferior to the HB region or mid/inferior septum are observed in 8–33% of patients with SF‐AVNRT . These data imply that a dislocated A‐FP input is a possible explanation for the cause of unexpected AV block, but the information on the A‐SP as the target of the procedure was absent in those studies.…”

Section: Discussionmentioning

confidence: 89%

Visualization of the Antegrade Fast and Slow Pathway Inputs in Patients with Slow‐Fast Atrioventricular Nodal Reentrant Tachycardia

Suzuki

Yoshida

Takei

et al. 2014

Pacing Clinical Electrophis

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“…To avoid injury to the fast pathway, the exact location of the His bundle and fast pathway should be confirmed. Tanaka et al reported that the dislocated fast pathway was frequently and uniformly observed among various forms of AVNRT, and was probably caused by inferior displacement of the His bundle [1]. Notably, no dislocated fast pathway at the CS roof level has been documented in patients with common AVNRT [2].…”

Section: Discussionmentioning

confidence: 99%

The inferior displacement of the His bundle and fast pathway in a patient with common type atrioventricular nodal tachycardia: Three‐dimensional computed tomography analysis

Kiuchi

Fukuzawa

Mori

et al. 2016

Journal of Arrhythmia

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A 66-year-old woman with palpitations was referred to our center for catheter ablation due to drug-refractory, common type atrioventricular nodal tachycardia (AVNRT). A selective slow pathway ablation was attempted. A fast junctional rhythm with transient ventriculoatrial block followed by transient prolongation of the A–H interval occurred immediately after the radiofrequency (RF) application at the coronary sinus ostium (CSOS) level. To assess the location of the fast pathway and His bundle, we sought to visualize the anatomy of the triangle of Koch (TOK) by three-dimensional computed tomography (CT).

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Incidence and Mechanism of Dislocated Fast Pathway in Various Forms of Atrioventricular Nodal Reentrant Tachycardia

Cited by 5 publications

References 21 publications

Evaluation of the input site and characteristics of the antegrade fast pathway based on three-dimensional bi-atrial stimulus-ventricle mapping

Evaluation of the input site and characteristics of the antegrade fast pathway based on three-dimensional bi-atrial stimulus-ventricle mapping

Visualization of the Antegrade Fast and Slow Pathway Inputs in Patients with Slow‐Fast Atrioventricular Nodal Reentrant Tachycardia

The inferior displacement of the His bundle and fast pathway in a patient with common type atrioventricular nodal tachycardia: Three‐dimensional computed tomography analysis

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