title: Novel electrophysiological characteristics of atrioventricular nodal continuous conduction curves in atrioventricular nodal re-entrant tachycardia with concomitant cavotricuspid isthmus-dependent atrial flutter.
abstract: OBJECTIVE
  The detailed electrophysiological characteristics of patients with both atrioventricular nodal re-entrant tachycardia (AVNRT) and atrial flutter (AFL) have not been clarified. This study investigated the related electrophysiological differences in a large series of patients undergoing radiofrequency catheter ablation of AVNRT.
  
  
  RESULTS
  A total of 1063 clinically documented AVNRT patients underwent catheter ablation were enrolled. Before the slow pathway (SP) ablation, 61 patients (5.7%) had inducible sustained cavotricuspid isthmus (CTI)-dependent AFL (Group 1), and the others (94.3%) without inducible sustained CTI-dependent AFL were defined as Group 2. The electrophysiological characteristics of these two groups and effect of the SP ablation on the inducibility of AFL were assessed. In Group 1, 36 patients (59%) had inducible/sustained AFL after the ablation of AVNRT and required a CTI ablation. The Group 1 patients had more AVNRT with continuous atrioventricular (AV) node function curves (P < 0.001, odds ratio = 7.55 [3.70-16.7], multivariate regression), and a younger age (P = 0.02, odds ratio = 1.02 [1.003-1.03], multivariate regression) than Group 2. The other characteristics were comparable between the two groups. The long-term follow-up (64.9 ± 34.9 months) revealed that the recurrence of AFL/atrial fibrillation was similar between the two groups (P > 0.05).
  
  
  CONCLUSIONS
  Atrioventricular nodal re-entrant tachycardia patients with concomitant CTI-dependent AFL had more continuous AV node function curves. Forty-one per cent of these patients had non-inducible AFL after the SP ablation, indicating a slow conduction isthmus in the triangle of Koch area.
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan Division of Cardiology, Taipei City Hospital, Ren-Ai Branch, Taipei, Taiwan.
authors.forename: Chung-Hsing
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan linyennjiang@gmail.com.
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Division of Cardiology, Department of Medicine, Changhua Christian Hospital, Changhua, Taiwan.
authors.forename: Hung-Kai
authors.initials: HK
authors.lastname: Huang
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Chiang
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Nizam's Institute of Medical Science, Hyderabad, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Allamsetty
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jo-Nan
authors.initials: JN
authors.lastname: Liao
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Fa-Po
authors.initials: FP
authors.lastname: Chung
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yao-Ting
authors.initials: YT
authors.lastname: Chang
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chin-Yu
authors.initials: CY
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan Faculty of Medicine, Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000601:surgery*; D001283:Atrioventricular Node / Q000503:physiopathology*; D017115:Catheter Ablation; D004562:Electrocardiography; D055724:Electrophysiological Phenomena; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012044:Regression Analysis; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D014261:Tricuspid Valve / Q000503:physiopathology*
keywords: Ablation; Atrial flutter; Atrioventricular nodal re-entrant tachycardia; Cavotricuspid isthmus