Successful treatment of tachycardia-induced cardiomyopathy secondary to dual atrioventricular nodal nonreentrant tachycardia using cryoablation

Rivner, Harold; Healy, Chris; Mitrani, Raul D.

doi:10.1016/j.hrcr.2016.09.005

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…To our knowledge, this is the first multicentre study in patients with dual antegrade conduction in the AV node. It covers about one-fifth of the so-far reported cases [8][9][10][11][12][21][22][23][24][25][26][27]. We demonstrate that (1) catheter ablation in patients with dual antegrade conduction is safe, effective, and results in good patient outcome during long-term follow-up and that (2) a co-existence of dual antegrade conduction in the AV node and AVNRT is more common than previously thought.…”

Section: Discussionmentioning

confidence: 65%

Outcomes in patients with dual antegrade conduction in the atrioventricular node: insights from a multicentre observational study

Hartmann

Jungen

Stec³

et al. 2020

Clin Res Cardiol

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Background Supraventricular tachycardias induced by dual antegrade conduction via the atrioventricular (AV) node are rare but often misdiagnosed with severe consequences for the affected patients. As long-term follow-up in these patients was not available so far, this study investigates outcomes in patients with dual antegrade conduction in the AV node. Methods and resultsIn this multicentre observational study, patients from six European centres were studied. Catheter ablation was performed in 17 patients (52 ± 16 years) with dual antegrade conduction via both AV nodal pathways between 2012 and 2018. Patients with the final diagnosis of a manifest dual AV nodal non-re-entrant tachycardia had a mean delay of the correct diagnosis of over 1 year (range 2-31 months). Two patients received prescription of non-indicated oral anticoagulation, two further patients suffered from inappropriate shocks of an implantable cardioverter defibrillator. In 12 patients, a co-existence of dual antegrade and re-entry conduction in the AV node was present. Mean fast pathway conduction time was 138 ± 61 ms and mean slow pathway conduction time was 593 ± 134 ms. Successful radiofrequency catheter ablation was performed in all patients. Post-procedurally oral anticoagulation was discontinued, without detection of cerebrovascular events or atrial fibrillation during a long-term follow-up of median 17 months (range 6-72 months). Conclusion This first multicentre study investigating patients with supraventricular tachycardia and dual antegrade conduction in the AV node demonstrates that catheter ablation is safe and effective while long-term patient outcome is good. Autonomic tone dependent changes in ante-vs. retrograde conduction via slow and/or fast pathway can challenge the diagnosis and therapy in some patients.

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Section: Discussionmentioning

confidence: 65%

Outcomes in patients with dual antegrade conduction in the atrioventricular node: insights from a multicentre observational study

Hartmann

Jungen

Stec³

et al. 2020

Clin Res Cardiol

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“…Historically, literature has identified the posteroseptal right atrium as the most effective ablation site for DAVNNT, mirroring the typical SP. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Notably, none of the previous studies [13][14][15] In this particular instance, traditional SP, encompassing RIE, did not resurface. We deduced this considering that both RF ablation and cryoablation within the right atrial septum did not impact the DAVNNT, while RF ablation at the left atrial septum successfully neutralized it.…”

Section: Discussionmentioning

confidence: 96%

“…Accurate DAVNNT diagnosis and treatment are paramount, especially considering that repeated DAVNNT episodes may lead to tachycardia-induced cardiomyopathy. [1][2][3][5][6][7][8][9][10][13][14][15]18 Crucially, DAVNNT remains a treatable arrhythmia, primarily addressed with SP ablation.…”

Section: Discussionmentioning

confidence: 99%

“…DAVNNT, a rare arrhythmia, is characterized by double antegrade AV nodal conduction. Historically, literature has identified the posteroseptal right atrium as the most effective ablation site for DAVNNT, mirroring the typical SP 1–19 . Notably, none of the previous studies have documented successful DAVNNT treatment via left atrial ablation.…”

Section: Discussionmentioning

confidence: 99%

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Validation of dual atrioventricular nodal physiology in dual atrioventricular nodal non‐reentrant tachycardia via adenosine triphosphate injection during atrial pacing: A novel insight into the role of leftward inferior extension

Arai,

Asakawa,

Sagawa

et al. 2024

Cardiovasc electrophysiol

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IntroductionDual atrioventricular nodal non‐reentrant tachycardia (DAVNNT) is a rare and challenging‐to‐diagnose arrhythmia, without previous reports associating it with a leftward inferior extension (LIE).MethodsDiagnosis was made using adenosine triphosphate (ATP) injection during atrial pacing in a suspected DAVNNT patient.ResultsAblation of the rightward inferior extension was unsuccessful in eliminating DAVNNT; however, subsequent ablation of the LIE successfully eradicated the arrhythmia.ConclusionThis unique case, marked by the first instance of DAVNNT caused by LIE, diagnosed through ATP injection, underscores the utility of this diagnostic approach and broadens the spectrum of our understanding and management of this condition.

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“…[ 6 , 12 , 13 ] The retrograde conduction between the ventricle and atrium was weak or absent, as has been observed in previous studies. [ 6 , 8 , 10 ] As described by Rivner et al [ 14 ] article, supraventricular beats can only conduct down the fast pathway, both the fast and slow AV nodal pathways, and the slow pathway only. Of note, as with this patient, atrial beats at a rate of 100 BPM are conducted along the slow pathway (Fig.…”

Section: Discussionmentioning

confidence: 99%

Frequent inappropriate implantable cardioverter defibrillator therapy was determined to be dual atrioventricular nodal non-reentrant tachycardia

Yin²,

Li³

et al. 2021

Medicine

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Rationale: Dual atrioventricular node non-reentrant tachycardia (DAVNNRT) is a rare arrhythmia. We present a case of inappropriate implantable cardioverter defibrillator (ICD) therapy caused by DAVNNRT. DAVNNRT is easily misdiagnosed as atrial fibrillation and is often identified as ventricular tachycardia (VT) by the supraventricular tachycardia-ventricular tachycardia (SVT-VT) discriminator of the ICD. Patient concerns: A 73-year-old man with ischemic heart disease (IHD) presented with palpitations accompanied by dyspnea and syncope. Frequent multifocal premature ventricular beats and non-sustained ventricular tachycardia were observed on ambulatory electrocardiography. The left ventricular ejection fraction decreased to 32%. Diagnosis: He was diagnosed with IHD, heart failure with reduced ejection fraction (HFrEF), and VT. Interventions : Initially, the patient received a single-chamber ICD implantation for secondary prevention of sudden death. He then suffered from inappropriate anti-tachycardia pacing (ATP)/shock therapy many times after the procedure. DAVNNRT was confirmed in an electrophysiology study (EPS), and radiofrequency ablation of the slow pathway successfully terminated this tachycardia. Outcomes: No episode of inappropriate ICD therapy or tachycardia occurred during the follow-up. Lessons: In conclusion, it is essential to have a full understanding of DAVNNRT and eliminate slow pathways for patients with DAVNNRT and be prepared to implant an ICD.

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Successful treatment of tachycardia-induced cardiomyopathy secondary to dual atrioventricular nodal nonreentrant tachycardia using cryoablation

Cited by 4 publications

References 8 publications

Outcomes in patients with dual antegrade conduction in the atrioventricular node: insights from a multicentre observational study

Outcomes in patients with dual antegrade conduction in the atrioventricular node: insights from a multicentre observational study

Validation of dual atrioventricular nodal physiology in dual atrioventricular nodal non‐reentrant tachycardia via adenosine triphosphate injection during atrial pacing: A novel insight into the role of leftward inferior extension

Frequent inappropriate implantable cardioverter defibrillator therapy was determined to be dual atrioventricular nodal non-reentrant tachycardia

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