title: Visualization of the antegrade fast and slow pathway inputs in patients with slow-fast atrioventricular nodal reentrant tachycardia.
abstract: BACKGROUND
  Mapping of the antegrade fast pathway (A-FP) exact sites and antegrade slow pathway (A-SP) input locations has not been well described.
  
  
  METHODS
  In 56 patients with slow-fast atrioventricular nodal reentrant tachycardia (SF-AVNRT), pacing during sinus rhythm and entrainment pacing during SF-AVNRT were performed at various sites in the triangle of Koch and coronary sinus (CS) to identify the A-FP and A-SP inputs. User-defined three-dimensional electro-anatomical mapping of the stimulus-His potential (St-H) interval and anatomical location was performed. The A-FP input was defined as the site of the shortest St-H interval, and A-SP input as the site of the shortest St-H interval and with a postpacing-interval equal to the tachycardia cycle length. The locations of the A-FP and A-SP inputs were mapped as a ratio of the distance between the His bundle (HB) and CS orifice (CSO), and the HB-CSO axis was divided into three zones: superior-, mid-, and inferior septum. The distance between the A-SP and A-FP inputs was calculated using the distance from each input to the HB and HB-CSO axis.
  
  
  RESULTS
  Only 30 patients were included in this study because the A-SP mapping failed in 26. The A-SP input was distributed to the superior septum in four, mid- or inferior septum in 25, and CS in one. An A-SP input which was located less than 10 mm from the A-FP input was observed in one of four patients with a superior septum A-SP.
  
  
  CONCLUSIONS
  An A-SP input at the superior septum seemed to be a potential risk for atrioventricular nodal injury during ablation.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoshida
authors.forename: Asumi
authors.initials: A
authors.lastname: Takei
authors.forename: Koji
authors.initials: K
authors.lastname: Fukuzawa
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kiuchi
authors.forename: Satoko
authors.initials: S
authors.lastname: Tanaka
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Itoh
authors.forename: Kimitake
authors.initials: K
authors.lastname: Imamura
authors.forename: Ryudo
authors.initials: R
authors.lastname: Fujiwara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yamashita
authors.forename: Akinori
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Konishi
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ichibori
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology* / Q000601:surgery
keywords: AVNRT; antegrade fast pathway; antegrade slow pathway