Shift in the earliest retrograde atrial activation site during the fast-slow form of atrioventricular nodal reentrant tachycardia after the radiofrequency modification of the atrioventricular node: is the atrium a necessary link?
Whether or not the perinodal atrium forms an upper link in the tachycardia circuit of the atypical form of AV nodal reentrant tachycardia (AVNRT) is controversial. We report a case with the fast-slow form of AVNRT in whom the earliest retrograde atrial activation site during the tachycardia changed from the right inferoseptum to the right superoseptum close to the His bundle without a change in the tachycardia cycle length following the radiofrequency energy applications to the earliest retrograde atrial activation site. It was speculated that a sub-atrial reentry with multiple atrial breakthroughs was the possible tachycardia mechanism in the present case.
Division of Cardiology, Tsuchiura Kyodo Hospital, 11-7 Manabeshin-Machi, Tsuchiura, Ibaraki, Japan. k-otomo@fj8.so-net.ne.jp
Kiyoshi
K
Otomo
Kikuya
K
Uno
Yasutoshi
Y
Nagata
Hiroshi
H
Taniguchi
Hideomi
H
Fujiwara
Yoshito
Y
Iesaka
D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000601:surgery*; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome