Adenosine-sensitive atrial tachycardia originating from the proximal coronary sinus

Horie, Tsutomu; Miyauchi, Yasushi; Kobayashi, Yoshinori; Iwasaki, Yu‐ki; Maruyama, Mitsunori; Katoh, Takao; Takano, Teruo

doi:10.1016/j.hrthm.2005.08.030

Cited by 16 publications

(22 citation statements)

References 26 publications

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“…For that reason, it is important to consider how close to the AV node we can discriminate AT by the delta‐VA interval. Adenosine‐sensitive reentrant AT originating from near Koch's triangle is one of the most difficult entities to distinguish from AVNRT, and it is believed that the transitional cells near the AV node are included in the AT circuit 1,5 . The circuit of the AT is generally in the proximity of the AV node; however, six cases of adenosine‐sensitive reentrant AT arising from near Koch's triangle in the present study had a delta‐VA interval of 52 ± 14 ms (range, 33–76 ms), and successful ablation was achieved without any influence on the AV conduction.…”

Section: Discussionmentioning

confidence: 54%

“…A diagnosis of each tachycardia was made based on the standard criteria 1–13 and the results of the radiofrequency ablation. AVNRT was considered typical when the septal VA interval was ≤70 ms and atypical if >70 ms. ORT was diagnosed if the VA conduction interval increased by greater than 20 ms with the development of bundle‐branch block or if ventricular extrastimuli during the tachycardia applied when the His bundle was refractory resulted in tachycardia termination or resetting without alteration in the atrial activation sequence.…”

Section: Methodsmentioning

confidence: 99%

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The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory

Maruyama

Kobayashi

Miyauchi

et al. 2007

Cardiovasc electrophysiol

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Section: Discussionmentioning

confidence: 54%

Section: Methodsmentioning

confidence: 99%

The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory

Maruyama

Kobayashi

Miyauchi

et al. 2007

Cardiovasc electrophysiol

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“…Although fractionated electrograms occupying a large percentage of tachycardia cycle length were not observed in their cases, a single extrastimulus delivered from the slow pathway region, distant from the EAAS, reset the AT with a postpacing interval identical to the AT cycle length. 16 Furthermore, radiofrequency energy application to this extrastimulation site terminated AT, suggesting that the slow pathway region is part of the reentrant circuit of adenosine-sensitive focal AT originating from the proximal coronary sinus. Thus, adeno- sine sensitivity is consistent with either calcium channeldependent microreentry or c-AMP-dependent triggered activity, as suggested by Iwai at al.…”

Section: Mechanism Of At and Its Substratementioning

confidence: 91%

“…[1][2][3][4]8 Regarding the sensitivity of adenosine and the mechanism of focal AT, Markowitz et al 15 proposed that adenosine sensitive focal AT is commonly due to triggered activity or automaticity; however, their adenosine-insensitive focal reentrant ATs showed low-amplitude, fractionated electrograms at the site of origin, which occupy a large percent of tachycardia cycle length, 15 different from the ATs presented in this study or those reported previously. [1][2][3][4]8 In addition, Horie et al 16 reported 7 cases of adenosine-sensitive focal reentrant ATs originating from the proximal coronary sinus. Although fractionated electrograms occupying a large percentage of tachycardia cycle length were not observed in their cases, a single extrastimulus delivered from the slow pathway region, distant from the EAAS, reset the AT with a postpacing interval identical to the AT cycle length.…”

Section: Mechanism Of At and Its Substratementioning

confidence: 99%

Analysis of the Anatomical Tachycardia Circuit in Verapamil-Sensitive Atrial Tachycardia Originating From the Vicinity of the Atrioventricular Node

Yamabe

Tanaka

Morihisa

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background-Calcium channel-dependent tissue has been suggested to be involved in the circuit of verapamil-sensitive atrial tachycardia originating from the atrioventricular (AV) node vicinity (V-AT), but little information exists. Methods and Results-To examine the tachycardia circuit of V-AT, a single extrastimulus was delivered during tachycardia to 10 sites of the intraatrial septum: the earliest atrial activation site; His bundle (HB) site; 3 arbitrarily divided sites on the AV junction extending from the HB site to the coronary sinus ostium (CSOS) (sites S, M, and I); the internal-CSOS, inferior-CSOS, superior-CSOS, posterior-CSOS, and posteroinferior-CSOS in 10 patients with V-AT. The longest coupling interval that reset V-AT and subsequent return cycle were measured. The longest coupling interval at earliest atrial activation site was significantly longer than the longest coupling interval at the HB site, site S, M, and I, internal-CSOS, inferior-CSOS, superior-CSOS, posterior-CSOS, and posteroinferior-CSOS, respectively (PϽ0.001 for HB site and PϽ0.0001 for the remaining 8 sites). The return cycle at earliest atrial activation site did not differ from the tachycardia cycle length, whereas those at the remaining 9 sites were significantly longer than tachycardia cycle length (PϽ0.001). Furthermore, a single extrastimulus delivered from sites inferior to the HB site advanced His potential without resetting V-AT in 7 patients in whom AV block was not observed during tachycardia. Conclusions-Atrial tissue within the Koch's triangle extending from the HB site to posteroinferior-CSOS is not involved in the tachycardia circuit. Verapamil-sensitive atrial tissue close to the AV node but not the AV nodal conducting system forms the tachycardia circuit of V-AT. (Circ Arrhythm Electrophysiol. 2010;3:54-62.)

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“…Several previous reports demonstrated that an RF energy delivery to the earliest atrial activation site could terminate the ATP‐AT without impairing the AV nodal conduction even though the ablation was applied within close vicinity of the His recording site . Ouyang et al, Ueyama et al, and Weber et al, reported that ATP‐ATs were successfully ablated in the noncoronary aortic cusp without inducing any injurious effects on the AV node.…”

Section: Discussionmentioning

confidence: 99%

Cryofreezing catheter ablation of adenosine triphosphate sensitive atrial tachycardia

Okishige

Shigeta

Nishimura

et al. 2019

Cardiovasc electrophysiol

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Introduction Adenosine triphosphate (ATP) sensitive atrial tachycardia (AT) has been treated by radiofrequency catheter ablation. Cryofreezing energy has emerged as a novel energy source for catheter ablation. The aim of this study was to investigate the efficacy and safety of cryofreezing ablation for ATP‐sensitive AT. Methods and Results A total of six patients with ATP‐sensitive ATs were included in this study. A single atrial extrastimulation was able to initiate and terminate these ATs in all six patients. The electrophysiological findings satisfied the diagnostic criteria of ATP‐sensitive AT. The ablation catheter was located at the earliest activation site of atrial excitation during the AT, and cryofreezing energy was delivered through a cryoablation catheter to perform cryomapping at temperature of −30 or −80°C. When cryomapping successfully terminated the ATs, cryoablation at a temperature of −80°C was subsequently performed. The earliest atrial activation during AT was recorded at the Koch's triangle area associated with a distinct intra‐atrial activation sequence from that recorded during ventricular pacing. Cryoablation was performed at successful cryomapping sites and resulted in the complete elimination of the AT in all six patients without affecting the bidirectional atrioventricular (AV) nodal conduction. Conclusion Cryofreezing energy was safe and effective in treating ATP‐sensitive ATs even in patients with its origins located in the vicinity of the AV node.

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Adenosine-sensitive atrial tachycardia originating from the proximal coronary sinus

Cited by 16 publications

References 26 publications

The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory

The VA Relationship After Differential Atrial Overdrive Pacing: A Novel Tool for the Diagnosis of Atrial Tachycardia in the Electrophysiologic Laboratory

Analysis of the Anatomical Tachycardia Circuit in Verapamil-Sensitive Atrial Tachycardia Originating From the Vicinity of the Atrioventricular Node

Cryofreezing catheter ablation of adenosine triphosphate sensitive atrial tachycardia

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