title: Atrioventricular node reentrant tachycardia in patients with congenitally corrected transposition of the great arteries and results of radiofrequency catheter ablation.
abstract: BACKGROUND
  We sought to investigate the feasibility of radiofrequency catheter ablation of atrioventricular node reentrant tachycardia and the ideal site for slow pathway (SP) ablation in congenitally corrected transposition of the great arteries.
  
  
  RESULTS
  Nine patients with congenitally corrected transposition of the great arteries referred for catheter ablation of atrioventricular node reentrant tachycardia were studied. A single His potential was recorded in 8 patients (89%, 6 {S,L,L} and 2 {I,D,D}). The earliest atrial activation during retrograde atrioventricular node conduction occurred at His bundle region (HBE; n=7) or shifting from HBE to coronary sinus ostium (n=1, {S,L,L}). Two anatomically separate His potentials were recorded in 1 patient (11%, {S,L,L}), one at the anteroseptum (HBE-1) and the other at the confluence of the pulmonary and mitral annulus (HBE-2). In 8 cases with a single His potential recorded, SP was abated at the posterior-midseptum, 2 ({S,L,L}) at the right posteroseptum, 1 ({S,L,L}) at the left posteroseptum, and 5 (3 {S,L,L} and 2 {I,D,D}) at the midseptum after failure of energy application at the posteroseptum. Junctional rhythm was observed during radiofrequency catheter ablation in all 8 of the cases. In the remaining patient with 2 anatomically separate His potentials recorded, SP was successfully ablated from the confluence of the pulmonary and mitral annulus, slightly below the HBE-2. Junctional rhythm was also induced during radiofrequency catheter ablation.
  
  
  CONCLUSIONS
  In {S,L,L} or {I,D,D}, radiofrequency catheter ablation of atrioventricular node reentrant tachycardia is feasible. SP input region can mainly be found in the posterior midseptum, especially in patients with single penetrating atrioventricular nodes. SP could usually be successfully ablated in these regions.
authors.affiliation: Arrhythmia Center and Clinical Electrophysiological Laboratory, FuWai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China.
authors.forename: Zili
authors.initials: Z
authors.lastname: Liao
authors.forename: Yu
authors.initials: Y
authors.lastname: Chang
authors.forename: Jian
authors.initials: J
authors.lastname: Ma
authors.forename: Pihua
authors.initials: P
authors.lastname: Fang
authors.forename: Kuijun
authors.initials: K
authors.lastname: Zhang
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Ren
authors.forename: Pingzhen
authors.initials: P
authors.lastname: Yang
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.forename: Jiqiang
authors.initials: J
authors.lastname: Hu
authors.forename: Qian
authors.initials: Q
authors.lastname: Yang
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D000080041:Congenitally Corrected Transposition of the Great Arteries; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D014188:Transposition of Great Vessels / Q000150:complications*; D055815:Young Adult