title: Patient with atrioventricular node reentrant tachycardia with eccentric retrograde left-sided activation: treatment with radiofrequency catheter ablation.
abstract: We describe a patient with supraventricular tachycardia with triple atrioventricular (AV) node pathway physiology. A discontinuous curve was present in the antegrade AV nodal function curves. During right ventricular pacing, the earliest retrograde atrial activation was recorded at the left-sided coronary sinus electrode. The retrograde ventricular-atrial interval was long and had decremental conduction. We induced a slow-slow AV node reentrant tachycardia (AVNRT) with eccentric retrograde left-sided activation. After slow pathway ablation, dual AV nodal pathway physiology was present. AVNRT with eccentric retrograde left-sided activation is relatively rare, and our findings suggest that eccentric retrograde left-sided atrial inputs consist partially of a slow pathway and disappear with slow pathway ablation.
authors.affiliation: Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Sakabe
authors.forename: T
authors.initials: T
authors.lastname: Wakatsuki
authors.forename: H
authors.initials: H
authors.lastname: Fujinaga
authors.forename: Y
authors.initials: Y
authors.lastname: Oishi
authors.forename: J
authors.initials: J
authors.lastname: Ikata
authors.forename: T
authors.initials: T
authors.lastname: Toyoshima
authors.forename: N
authors.initials: N
authors.lastname: Hiura
authors.forename: A
authors.initials: A
authors.lastname: Nishikado
authors.forename: T
authors.initials: T
authors.lastname: Oki
authors.forename: S
authors.initials: S
authors.lastname: Ito
mesh_terms: D016279:Atrial Function, Left; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D016278:Ventricular Function, Right