Atypical Atrioventricular Nodal Reentry Tachycardia with Eccentric Retrograde Left-Sided Activation of Coronary Sinus

Trajkov I.; D. Kovacevik; N. Gjorgov

Atypical Atrioventricular Nodal Reentry Tachycardia with Eccentric Retrograde Left-Sided Activation of Coronary Sinus

Trajkov I. §

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D. Kovacevik ‡

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N. Gjorgov ‡

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§ Clinical Hospital Acibadem-Sistina, Department of ca...

‡ Clinical Hospital Acibadem-Sistina, Department of ca...

Atypical Atrioventricular Nodal Reentry Tachycardia with Eccentric Retrograde Left-Sided Activation of Coronary Sinus

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Abstract

Background: Recent anatomical and electro- physiological studies demonstrated, that in the human atrioventricular node there are two main extension, rightward and leftward posterior nodal extension (LPNE). The occurrence of eccentric retrograde atrial activation has been demonstrated to be from 6 to 8% in patients with AVNRT by several previous reports. Objectives: The study was performed to confirm that standard right atrium ablation is effective and successful for atrioventricular node reentry tachycardia (AVNRT) with eccentric retrograde left-sided activation, masquerading a tachycardia which look like as a tachycardia using left accessory pathway. Methods and Results: During a 7 years period (from 2002 to 2008), 865 consecutive patients underwent electrophysiological study. In the group with atrioventricular node reentry tachycardia (AVNRT) there were 178 patients. In the group with typical fast-slow AVNRT (162 pts) there was concentric retrograde activation of the both atrium. The 16 patients were with atypical AVNRT (10 pts with slow-slow AVNRT and 6 pts with LPNE). The ablation was performed, in all patients in the triangle of Koch on the slow pathway of atrioventricular node. The successful rate of ablation was 99.4 % (177/178 pts). The incidence of AVNRT with eccentric retrograde activation was 3.4%. In the follow up period (16 + 12 months), there is no recurrence of AVNRT in the group with LPNE. Conclusions: This study demonstrated the different electrophysiologic characteristics between the AVNRT patients with eccentric and concentric retrograde atrial activation. Standard ablation, but a little bit higher in the triangle of Koch, closer to the fast pathway, in the right atrium is effective and successful for AVNRT with retrograde left eccentric conduction in the coronary sinus.

References

11 Cites in Article

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Funding

No external funding was declared for this work.

Conflict of Interest

The authors declare no conflict of interest.

Ethical Approval

No ethics committee approval was required for this article type.

Data Availability

Not applicable for this article.

How to Cite This Article

Trajkov I., D. Kovacevik, N. Gjorgov. 2013. "Atypical Atrioventricular Nodal Reentry Tachycardia with Eccentric Retrograde Left-Sided Activation of Coronary Sinus". Global Journal of Medical Research - I: Surgeries & Cardiovascular System GJMR-I Volume 13 (GJMR Volume 13 Issue 8 (I2)).

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GJMR Volume 13 Issue 8 (I2)

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Journal Specifications

Crossref Journal DOI 10.17406/gjmra

Print ISSN 0975-5888

e-ISSN 2249-4618

Keywords

atypical AVNRT catheter ablation eccentric retrograde activation

Classification

GJMR-I Classification NLMC Code: WX 218

Submission ReceivedApril 8, 2013
Peer Review Double Blind
Handling Editor
Accepted May 4, 2013
Published March 29, 2013

Version of record

v1.2

Issue date

March 29, 2013

Language

English

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Total Score: 103

Country: Macedonia

Subject: Global Journal of Medical Research - I: Surgeries & Cardiovascular System

Authors: Trajkov I., Kovacevik D., Gjorgov N. (PhD/Dr. count: 0)

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