Atrioventricular nodal reentrant tachycardia: anatomical and electrophysiological considerations.
Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common regular narrow QRS tachycardias. Although the principal understanding of the physiology of dual atrioventricular conduction as a substrate for the reentry mechanism in AVNRT has not changed during the last 25 years, there is still some uncertainty with regard to the exact circuit delineation. At least four forms of AVNRT have been described and several possible circuits have been proposed. Although the refinement of our knowledge about AVNRT seems to be purely academic since further insight will probably not increase the success rate of treatment by radiofrequency catheter ablation, AVNRT continues to puzzle both clinical and basic electrophysiologists. The authors summarize our present knowledge about AVNRT and stress the unique features of the atrioventricular junction anatomy and the current opinions on the reentrant impulse propagation.
Bulava
Alan
A
Department of Cardiac Diseases, San Filippo Neri Hospital, Rome, Italy. alanbulava@hotmail.com
Peichl
Petr
P
Pandozi
Claudio
C
Castro
Antonio
A
Lamberti
Filippo
F
Calò
Leonardo
L
Loricchio
Maria Luisa
ML
Santini
Massimo
M
D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008953:Models, Anatomic; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D014463:Ultrasonography