Coronary sinus diameter by echocardiography to differentiate atrioventricular nodal reentrant tachycardia from atrioventricular reentrant tachycardia

Babu, Ezhumalai; Satheesh, Santhosh; Anantha, Ajith; Packirisamy, Gobu; Balachander, Jayaraman; Selvaraj, Raja

doi:10.5603/cj.a2013.0088

Cited by 11 publications

(8 citation statements)

References 21 publications

(29 reference statements)

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“…In particular, chronic pressure overload from PH could lead to remodeling of the right heart with hypertrophy and fibrosis, the latter of which provided the trigger substrate for CTI-independent atrial flutter (Medi et al, 2012). Furthermore, the hypertensive pulmonary vasculature eventually induced enlargement of the right atrium and coronary sinus ostium, which has been shown to be associated with the onset of AVNRT and CTI-dependent atrial flutter (Doig et al, 1995;Okumura et al, 2004;Ezhumalai et al, 2014). More interestingly, the two abovementioned arrhythmias might be involved in a common area of perinodal atrium adjacent to coronary sinus ostium in their tachycardia circuits (Okumura et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Patients With Pulmonary Hypertension: Feasibility and Long-Term Outcome

et al. 2021

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BackgroundSupraventricular tachycardia (SVT) occurs commonly and is strongly correlated with clinical deterioration in patients with pulmonary hypertension (PH). This study aimed to investigate the feasibility and long-term outcome of radiofrequency catheter ablation (RFCA) in PH patients with SVT.Materials and MethodsConsecutive PH patients with SVT who were scheduled to undergo electrophysiological study and RFCA between September 2010 and July 2019 were included. The acute results and long-term success of RFCA were assessed after the procedure.ResultsIn total, 71 PH patients with 76 episodes of SVT were analyzed. Cavotricuspid isthmus-dependent atrial flutter (n = 33, 43.5%) was the most common SVT type, followed by atrioventricular nodal reentrant tachycardia (n = 16, 21.1%). Of the 71 patients, 60 (84.5%) underwent successful electrophysiological study and were subsequently treated by RFCA. Among them, acute sinus rhythm was restored in 54 (90.0%) patients, and procedure-related complications were observed in 4 (6.7%) patients. Univariate logistic regression analysis showed that cavotricuspid isthmus-independent atrial flutter [odds ratio (OR) 25.00, 95% confidence interval (CI) 3.45–180.98, p = 0.001] and wider pulmonary artery diameter (OR 1.19, 95% CI 1.03–1.38; p = 0.016) were associated with RFCA failure. During a median follow-up of 36 (range, 3–108) months, 7 patients with atrial flutter experienced recurrence, yielding a 78.3% 3-year success rate for RFCA treatment.ConclusionThe findings suggest that RFCA of SVT in PH patients is feasible and has a good long-term success rate. Cavotricuspid isthmus-independent atrial flutter and a wider PAD could increase the risk for ablation failure.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Patients With Pulmonary Hypertension: Feasibility and Long-Term Outcome

et al. 2021

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“…More recently, Ezhumalai et al. [3] demonstrated with the use of echocardiography instead of angiography that the CS ostia also had a larger diameter in patients with AVNRT when compared with patients with AVRT.…”

Section: Discussionmentioning

confidence: 99%

“…There is probably an anatomical reason for this impression. The CS ostial diameter is larger in patients with AVNRT when compared with other forms of PSVT [3,4]. However, this general perception has not yet been clinically tested in a prospective way in patients with PSVT.…”

Section: Introductionmentioning

confidence: 99%

Coronary sinus cannulation predicts atrioventricular nodal reentry as mechanism of supraventricular tachycardia

Leiria

Branchi

Sant’Anna

et al. 2019

Indian Pacing and Electrophysiology Journal

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IntroductionCommon clinical teaching, for invasive electrophysiology, is that if the first year fellow cannulates the coronary sinus (CS) in his first attempt, the arrhythmia is more likely to be atrioventricular nodal reentry tachycardia (AVNRT). This general perception has not yet been clinically tested. We evaluated this theory in prospective patients undergoing an electrophysiological study (EPS) for paroxysmal supraventricular tachycardia (PSVT).MethodsCohort study. CS ease of cannulation (CSCS) was graded as: 1) 1st year fellow cannulates in first attempt; 2) 1st year fellow needs more than one attempt or maneuver to cannulate the CS; 3) staff physician cannulates in first attempt after the fellow was unsuccessful; 4) staff physician requires more than one maneuver to cannulate the CS; 5) staff physician judges that the cannulation process was extremely difficult.ResultsOf the 1361 patients undergoing EPS in our institution, 165 were selected. Age was 49 ± 15 years. AVNRT occurred in 77.6%, atrioventricular reentry tachycardia (AVRT) in 15.1% and atrial tachycardia (AT) in 7.3% of cases. The CSCS = 1 was more prevalent in AVNRT, 89% versus 68% AVRT and 58.3% of AT (P = 0.0005). Patients with CSCS = 1 have a higher chance of the PSVT being AVNRT (odds ratio: 4.41; 95CI: 1.84–10.56; P = 0.0009).ConclusionThe CSCS predicts the likelihood of the induced PSVT being AVNRT as compared to AVRT and AT. More studies are required to try to associate this finding to clinical patient characteristics to create a score for PSVT mechanism prediction.

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“…The mean dimension of the longest diameter of its oval-shaped ostium fluctuates around 9-15 mm [23,24]. The excessive diameter of the CSO is considered as a risk factor of the AV nodal re-entrant tachycardia [25]. Clinically, the CSO is utilised as a passage to the left atrial and left ventricular epicardium during cardiac resynchronisation therapy, catheter ablation of cardiac arrhythmias, defibrillation, perfusion therapy, mitral valve annuloplasty, targeted drug delivery, or retrograde cardioplegia administration [23,26].…”

Section: Coronary Sinus Ostium and Thebesian Valvementioning

confidence: 99%

Clinical anatomy of human heart atria and interatrial septum — anatomical basis for interventional cardiologists and electrocardiologists. Part 1: right atrium and interatrial septum

2018

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Coronary sinus diameter by echocardiography to differentiate atrioventricular nodal reentrant tachycardia from atrioventricular reentrant tachycardia

Cited by 11 publications

References 21 publications

Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Patients With Pulmonary Hypertension: Feasibility and Long-Term Outcome

Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Patients With Pulmonary Hypertension: Feasibility and Long-Term Outcome

Coronary sinus cannulation predicts atrioventricular nodal reentry as mechanism of supraventricular tachycardia

Clinical anatomy of human heart atria and interatrial septum — anatomical basis for interventional cardiologists and electrocardiologists. Part 1: right atrium and interatrial septum

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