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To the Editor:We are responding to the recent article by Yamabe et al1 who concluded that a retrograde pathway extending from the His bundle (Hb) to the area below the coronary sinus os “is an integral limb of the reentry circuit in fast/slow atrioventricular nodal reentrant tachycardia (AVNRT).” In a previous report,2 the same area was found to be involved in antegrade activation during slow/fast AVNRT. Thus, only one limb of the reentrant circuit has been delineated in which activation moves in opposite directions for the two varieties of AVNRT.Our recent studies of AVNRT in the rabbit heart3,4⇓ provide evidence suggesting that the entire AVNRT circuit is located within the triangle of Koch. Specifically, in 19 of 72 AV junctional preparations, the antegrade and retrograde limbs were located in the transitional cells closest to the tricuspid annulus and those transitional cells located just below the tendon of …

Demonstration of the Exact Anatomic Tachycardia Circuit in the Fast-Slow Form of Atrioventricular Nodal Reentrant Tachycardia