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Adenosine‐Sensitive Atrial Reentrant Tachycardia Originating from the Atrioventricular Nodal Transitional Area
Author(s) -
IESAKA YOSHITO,
TAKAHASHI ATSUSHI,
GOYA MASAHIKO,
SOEJIMA YOHKOH,
OKAMOTO YOSHIHIRO,
FUJIWARA HIDEOMI,
AONUMA KAZUTAKA,
NOGAMI AKIHTKO,
HIROE MICHIAKI,
MARUMO FUMIAKI,
HIRAOKA MASAYASU
Publication year - 1997
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1997.tb00846.x
Subject(s) - medicine , tachycardia , cardiology , reentry , atrial tachycardia , nodal , supraventricular tachycardia , atrioventricular node , adenosine , ablation , p wave , catheter ablation , anesthesia , atrial fibrillation
Adenosine‐Sensitive AT from AVN Area. Introduction : Atrial tachycardia shows wide variations in its electrophysiologic properties and sites of origin. We report an atrial tachycardia with ECG manifestations and electrophysiologic characteristics similar to an atypical form of AV nodal reentrant tachycardia (AVNRT). Methods and Results : This supraventricular tachycardia was observed in 11 patients. It was initiated by atrial extrastimulation with an inverse relationship between the coupling interval of an extrastimulus and the postextrastimulus interval. Its induction was not related to a jump in the AH interval, and its perpetuation was independent of conduction block in the AV node. Ventricular pacing during tachycardia demonstrated AV dissociation without affecting the atrial cycle length. A very small dose of adenosine triphosphate (mean 3.9 ± 1.2 mg) could terminate the tachycardia. The earliest atrial activation during tachycardia was recorded at the low anteroseptal right atrium with a different intra‐atrial activation sequence from that recorded during ventricular pacing, where the tachycardia was successfully ablated in 9 of 10 attempted patients. Bidirectional AV nodal conduction remained unatttched after successful ablation. Conclusion : There may he an entity of adenosine‐sensitive atrial tachycardia probably due to focal reentry within the AV node or its transitional tissues without involvement of the AV nodal pathways. This tachycardia can he ablated without disturbing AV nodal conduction from the right atrial septum.