Novel use of atrial overdrive pacing to rapidly differentiate junctional tachycardia from atrioventricular nodal reentrant tachycardia

Fan, Roger; Tardos, Jonathan G.; Almasry, Ibrahim; Barbera, S; Rashba, Eric J.; Iwai, Sei

doi:10.1016/j.hrthm.2011.01.011

Cited by 65 publications

(54 citation statements)

References 8 publications

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“…21,22 Atrial extrastimulation and overdrive pacing were not systematically performed during tachycardia to exclude junctional tachycardia or assess VA linking. [23][24][25] However, because focal junctional tachycardia associated with retrograde conduction over the SP is extremely rare and none of our tachycardias exhibited nonreentrant behavior (eg, warm-up/cool-down phenomena, initiation after a spontaneous junctional complex), we are confident of our diagnoses. In addition, the value of VA linking in long RP tachycardias is unclear because VA intervals can vary significantly during atypical ORT and AVNRT because of decremental conduction over the AP and SP, respectively.…”

Section: Limitationsmentioning

confidence: 78%

Electrophysiological Features Differentiating the Atypical Atrioventricular Node–Dependent Long RP Supraventricular Tachycardias

Frisch

Pavri

et al. 2013

Circ: Arrhythmia and Electrophysiology

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E stablishing the diagnosis of an atypical atrioventricular (AV) node-dependent long RP supraventricular tachycardia (SVT) can be difficult. Standard diagnostic criteria are lacking and often extrapolated from pacing maneuvers applied to the more common short RP SVT. Long RP SVTs involving concealed nodofascicular (NF) accessory pathways (AP) are particularly rare with descriptions limited to isolated case reports. [1][2][3][4] Prolonged conduction over the slow pathway (SP) of the AV node or a decremental AP after entrainment from the ventricle can produce A-A-V patterns that might be mistaken for atrial tachycardia (AT). 5 In addition, slow AP conduction after entrainment of an atypical orthodromic reciprocating tachycardia (ORT) can generate long postpacing intervals (PPI) that cause misdiagnosis of AV nodal reentrant tachycardia (AVNRT), despite correction for delay in the AV node (cPPI). [5][6][7] This study sought to evaluate the electrophysiological features and criteria differentiating the 4 atypical AV node-dependent long RP SVTs: atypical AVNRT, atypical AVNRT with a concealed, bystander NF AP (atypical AVNRT/NF AP), ORT using a concealed, slowly conducting, decremental AV AP (also called the permanent form of junctional reciprocating tachycardia [PJRT]), and ORT using a concealed NF AP (also called NF reentrant tachycardia [NFRT]

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Section: Limitationsmentioning

confidence: 78%

Electrophysiological Features Differentiating the Atypical Atrioventricular Node–Dependent Long RP Supraventricular Tachycardias

Frisch

Pavri

et al. 2013

Circ: Arrhythmia and Electrophysiology

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“…There are a few maneuvers to differentiate between AVNRT and JT, which are summarized in Table . The patient was planned for medical management in view of difficulty in induction, and higher risk of AV block associated with the ablation of JT.…”

Section: Discussionmentioning

confidence: 99%

Supraventricular tachycardia with abrupt onset and termination: What is the mechanism?

Prabhu

Anderson

Sparks

2018

Cardiovasc electrophysiol

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“…Each type of SVT was diagnosed based on the findings from the electrophysiological study . The diagnosis of junctional ectopic tachycardia (JET) was confirmed by ventricular atrial dissociation, the rate variability, narrow QRS complex, no physiology of dual atrioventricular node (AVN), spontaneous initiation and termination, and/or responses to atrial/ventricular pacing …”

Section: Methodsmentioning

confidence: 99%

Outcome of combined cryo‐ and radiofrequency‐catheter ablation in patients with supraventricular tachycardias

Miyamoto

Kapa

Mulpuru

et al. 2019

Cardiovasc electrophysiol

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Background There are few data regarding the outcome of a combined cryo‐ and radiofrequency (RF)‐catheter ablation of various types of supraventricular tachycardias (SVTs) originating from near the normal conduction system. METHODS We analyzed all patients undergoing combined cryo‐ and RF‐ catheter ablation at Mayo Clinic, Rochester, MN as part of the ablation of SVTs with potential risks of injury to the normal conduction system. This study aimed to assess the outcome of a combined cryo‐ and RF‐catheter ablation of various types of SVTs. RESULTS The study population consisted of 54 patients (38 ± 17 years, 32 men). A combined cryo‐ and RF‐catheter ablation was attempted for septal accessary pathways (APs) in 26, atrioventricular nodal reentrant tachycardia (AVNRT) in 14, atrial tachycardia (AT) in 7, and junctional ectopic tachycardia in 7 patients. Forty‐one patients (76%) were successfully ablated with cryoablation, and RF ablation after an unsuccessful cryoablation ablated the SVTs successfully at the same location in 6 patients (11%). Complication occurred in 1 patient (deep vein thrombosis). The cumulative freedom from SVT rate at 30 days after the procedure was 78% and there was no significant difference in the recurrence rate among the SVTs. CONCLUSION A combined cryo‐ and RF‐catheter ablation is clinically effective in patients undergoing SVT ablation with the potential risk of injury to the normal conduction system.

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Novel use of atrial overdrive pacing to rapidly differentiate junctional tachycardia from atrioventricular nodal reentrant tachycardia

Cited by 65 publications

References 8 publications

Electrophysiological Features Differentiating the Atypical Atrioventricular Node–Dependent Long RP Supraventricular Tachycardias

Electrophysiological Features Differentiating the Atypical Atrioventricular Node–Dependent Long RP Supraventricular Tachycardias

Supraventricular tachycardia with abrupt onset and termination: What is the mechanism?

Outcome of combined cryo‐ and radiofrequency‐catheter ablation in patients with supraventricular tachycardias

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