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Atrioventricular Nodal Reentry: Evidence Supporting an Intranodal Location
Author(s) -
JOSEPHSON MARK E.,
MILLER JOHN M.
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb01632.x
Subject(s) - reentry , medicine , nodal , cardiology , refractory period , supraventricular tachycardia , atrioventricular node , atrium (architecture) , tachycardia , atrial fibrillation
The exact site of the reentrant circuit in AV nodal reentry remains controversial. While recent ablative techniques have yielded information, the interpretation of which suggests that the atrium is required, other explanations for these interpretations are available. Prior pathophysiological studies with three‐dimensional reconstruction of the node suggest that it is a highly anisotropic structure and extends through Koch's Triangle. Data from humans suggesting the atria are not necessary include the presence of AV dissociation during supraventricular tachycardia (SVT), depolarization of atrial tissue surrounding the node without affecting SVT, pacing induced AH intervals exceeding those during SVT, and site dependency ofa critical AH interval (exceeding afrial refractoriness) that is required for initiation of AV nodal reentry.