Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval

Li, Y G; Grönefeld, Gerian; Bender, Birgit; Machura, C; Hohnloser, Stefan H.

doi:10.1053/euhj.2000.2182

Cited by 62 publications

(55 citation statements)

References 22 publications

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“…Pace-termination is performed by pacing the atrium at a rate starting approximately 5% to 10% above the atrial flutter rate to achieve atrial entrainment and by maintaining pacing for ≥15 seconds, with repeated attempts at incrementally faster rates (reducing the pacing cycle length by 5 to 10 ms until normal sinus rhythm or AF occurs. 364 When AF is precipitated, this is often more easily rate-controlled and may subsequently revert to sinus rhythm. Recommendations for anticoagulation with regard to pace-termination of atrial flutter are the same as those for chemical or electrical conversion of AF.…”

Section: -364mentioning

confidence: 99%

“…364 Atrial pacing is more commonly applied in situations in which atrial wires are already in place, such as in the postoperative setting or in patients with programmable cardiac implanted electrical devices. A temporary pacing wire may also be placed and atrial pacing for termination of atrial flutter can be useful when sedation is contraindicated, or in the setting of digitalis toxicity, in which DC cardioversion is contraindicated.…”

Section: -364mentioning

confidence: 99%

See 1 more Smart Citation

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Page¹,

Joglar²,

Caldwell³

et al. 2016

Circulation

337

127

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Section: -364mentioning

confidence: 99%

Section: -364mentioning

confidence: 99%

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Page¹,

Joglar²,

Caldwell³

et al. 2016

Circulation

337

127

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“…53 The preexistence of first-degree heart block may carry a higher risk for late AV block and slow pathway modification, as opposed to complete elimination, is probably preferable in this setting. 54 …”

Section: Therapymentioning

confidence: 99%

Atrioventricular Nodal Reentrant Tachycardia

2010

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A trioventricular nodal reentrant tachycardia (AVNRT) represents the most common regular supraventricular arrhythmia in humans. 1 The precise anatomic site and nature of the pathways involved have not yet been established, and several attempts to provide a reasonable hypothesis based on anatomic or anisotropic models have been made. 2 There has been considerable evidence that the right and left inferior extensions of the human atrioventricular (AV) node and the atrionodal inputs they facilitate may provide the anatomic substrate of the slow pathway, and a comprehensive model of the tachycardia circuit for all forms of AVNRT based on the concept of atrionodal inputs has been proposed. 2 Still, however, the circuit of AVNRT remains elusive. Recently, time-honored conventional schemes for the diagnosis and classification of the various forms of the arrhythmia have been refuted in part by evolving evidence. Recognition of the various types of AVNRT is important, however, to expedite diagnosis and allow implementation of appropriate ablation therapy without complications. We present an update on AVNRT with a particular emphasis on electrophysiological criteria used for the differential diagnosis of regular, supraventricular tachycardias. ECG PresentationTypically, AVNRT is a narrow-complex tachycardia, ie, QRS duration Ͻ120 ms, unless aberrant conduction, which is usually of the right bundle-branch type, or a previous conduction defect exists. Tachycardia-related ST depression and RR-interval variation may be seen. RR alternans in AVNRT has been attributed to the proposed model of a figure of 8 reentry with continuous crossing over of antegrade activation through an inferior input to the contralateral superior input via the node. 2 In the typical form of AVNRT (slow-fast), abnormal (retrograde) PЈ waves are constantly related to the QRS and in the majority of cases are indiscernible or very close to the QRS complex (RPЈ/RR Ͻ0.5). Thus, PЈ waves are either masked by the QRS complex or seen as a small terminal PЈ wave that is not present during sinus rhythm (Figure 1). In the atypical form of AVNRT (fast-slow), PЈ waves are clearly visible before the QRS, ie, RPЈ/PЈR Ͼ0.75 (Figure 2), denoting a "long RP tachycardia," and are negative in leads II, III, aVF, and V 6 but positive in V 1 . PЈ waves are shallow in the inferior leads in the rare form of anterior fast-slow AVNRT. 3 Although AV dissociation is usually not seen, it can occur because neither the atria or the ventricles are necessary for the reentry circuit. If the tachycardia is initiated by atrial ectopic beats, the initial (ectopic) PЈ wave usually differs from the subsequent (retrograde) PЈ waves (Figure 1).

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“…Hence steroids were used for their anti-inflammatory and anti-edematous properties. Very long preexisting PR interval, dual AV node physiology and the total elimination of slow pathway are predictors for the development of permanent AV block (2,7,8) . Lately cryotherapy ablation an expensive method was introduced for the prevention of the development of inadvertent AV block by testing the ablation site prior to producing permanent lesions (9) .…”

Section: Discussionmentioning

confidence: 99%

Transvenous Radiofrequency Ablation Therapy in the Treatment of Arrhythmias: A Single Center Experience

Gökdeniz¹,

Aykan²,

Yıldız³

et al. 2013

Kosuyolu Kalp Derg

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Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval

Cited by 62 publications

References 22 publications

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Atrioventricular Nodal Reentrant Tachycardia

Transvenous Radiofrequency Ablation Therapy in the Treatment of Arrhythmias: A Single Center Experience

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