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Long Postpacing Interval After Entrainment of Tachycardia Including a Slow Conduction Zone Within the Circuit
Author(s) -
KINJO TAKAHIKO,
SASAKI SHINGO,
KIMURA MASAOMI,
OWADA SHINGEN,
HORIUCHI DAISUKE,
SASAKI KENICHI,
ITOH TAIHEI,
ISHIDA YUJI,
SHOJI YOSHIHIRO,
NISHIZAKI KIMITAKA,
TSUSHIMA YUICHI,
TOMITA HIROFUMI,
OKUMURA KEN
Publication year - 2016
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/jce.13014
Subject(s) - medicine , cardiology , tachycardia , atrial flutter , reentry , atrioventricular reentrant tachycardia , coronary sinus , orthodromic , atrial tachycardia , accessory pathway , catheter ablation , anesthesia , ablation , electrophysiology
Long Postpacing Interval Caused by Decremental Conduction Backgrounds Postpacing interval (PPI) measured after entrainment pacing describes the distance between pacing site and reentrant circuit. However, the influential features to PPI remain to be elucidated. Methods and Results This study included 22 cases with slow/fast atrioventricular (AV) nodal reentrant tachycardia (AVNRT), 14 orthodromic AV reciprocating tachycardia (AVRT) using an accessary pathway, 22 typical atrial flutter (AFL), and 18 other macroreentrant atrial tachycardia (atypical AFL). Rapid pacing at a pacing cycle length (PCL) 5% shorter than tachycardia cycle length (TCL) was done from a site on or close to the reentry circuit. Pacing sites included the coronary sinus ostium in AVNRT, earliest atrial activation site in AVRT, and cavotricuspid isthmus in typical AFL. In atypical AFL, tachycardia circuit was determined on the basis of CARTO mapping, and then the pacing site was. TCL was significantly longer in AVNRT and AVRT than in typical AFL and atypical AFL (both P < 0.05). PCL minus TCL value was similar among the 4 groups. PPI minus TCL value (milliseconds) was significantly longer in AVNRT (median, 40 [IQR, 29–60.8]) and AVRT (34 [20–47]) than in typical AFL (0 [0–4]) and atypical AFL (3.5 [0–8]) (both P < 0.05). Furthermore, PPI minus TCL was prolonged with shortening of PCL in AVNRT and AVRT (both P < 0.05), whereas it was unchanged in typical AFL (P = 0.50). Conclusion PPI after concealed entrainment is prolonged compared with TCL when the reentry circuit involves a slow conduction zone with a decremental conduction property such as the AV node.