Patient with atrioventricular node reentrant tachycardia with eccentric retrograde left-sided activation: treatment with radiofrequency catheter ablation.
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.
Sakabe
K
K
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Japan.
Wakatsuki
T
T
Fujinaga
H
H
Oishi
Y
Y
Ikata
J
J
Toyoshima
T
T
Hiura
N
N
Nishikado
A
A
Oki
T
T
Ito
S
S
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