The Response of the Slow Atrioventricular Nodal Pathway to Temperature

Kawabata, Mihoko; Hirao, Kazuyuki; Toshida, Nobuo; Suzuki, Fumio; Hiejima, Kazumasa

doi:10.1253/jcj.63.427

Cited by 4 publications

(3 citation statements)

References 28 publications

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“…Furthermore, the fewer junctional cycles observed during RF application at the posterior end of the SP compared with the site of successful ablation (Table 2) might reflect differences in thermally mediated enhanced automaticity between the perinodal tissue and the AV nodal tissue near the compact AV node. Thus we believe that, when using a stepwise approach along the tricuspid annulus, the posterior end of the right posterior extension could be detected by triggering the junctional rhythm as a marker of AV nodal tissue ablation [27–30]. SP-L, which in the present study was measured precisely between the most proximal H and the proximal end of the SP, might have reflected the actual conduction across the SP during tachycardia.…”

Section: Discussionmentioning

confidence: 93%

“…Accelerated junctional rhythm was defined as any sequence of premature depolarizations propagating from the AV junctional region in a centrifugal direction. We analyzed the characteristics of the rhythm during RF application at the posterior end of the SP and at the site of successful ablation, including the mean number of junctional cycles and the total number of cycles/30 s, the time from the initiation of RF energy delivery to the onset of accelerated junctional rhythm, the total duration of junctional rhythm, and the temperature and power at the onset of the rhythm [29, 30]. We also (a) measured the distance between the earliest H recording and the site of last RF application (SucABL-L) after which successful ablation (as defined earlier) was confirmed (Fig.…”

Section: Methodsmentioning

confidence: 99%

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Electroanatomically estimated length of slow pathway in atrioventricular nodal reentrant tachycardia

et al. 2013

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The length of the slow pathway (SP-L) in atrioventricular (AV) nodal reentrant tachycardia (NRT) has never been measured clinically. We studied the relationship among (a) SP-L, i.e., the distance between the most proximal His bundle (H) recording and the most posterior site of radiofrequency (RF) delivery associated with a junctional rhythm, (b) the length of Koch’s triangle (Koch-L), (c) the conduction time over the slow pathway (SP-T), measured by the AH interval during AVNRT at baseline, and (d) the distance between H and the site of successful ablation (SucABL-L) in 26 women and 20 men (mean age 64.6 ± 11.6 years), using a stepwise approach and an electroanatomic mapping system (EAMS). SP-L (15.0 ± 5.8 mm) was correlated with Koch-L (18.6 ± 5.6 mm; R2 = 0.1665, P < 0.005), SP-T (415 ± 100 ms; R2 = 0.3425, P = 0.036), and SucABL-L (11.6 ± 4.7 mm; R2 = 0.5243, P < 0.0001). The site of successful ablation was located within 10 mm of the posterior end of the SP in 38 patients (82.6 %). EAMS-guided RF ablation, using a stepwise approach, revealed individual variations in SP-L related to the size of Koch’s triangle and AH interval during AVNRT. Since the site of successful ablation was also correlated with SP-L and was usually located near the posterior end of the SP, ablating anteriorly, away from the posterior end, is not a prerequisite for the success of ablation procedures.

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Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Electroanatomically estimated length of slow pathway in atrioventricular nodal reentrant tachycardia

et al. 2013

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“…It has been proposed that JR results from enhanced automaticity of the compact AV node in response to thermal injury of the slow pathway. 11 Therefore, it is reasonable to postulate that a floppy magnetic ablation catheter with an excellent tissue contact is less prone to microdislodgement toward the compact AV node than a stiffer manual catheter. These characteristics of magnetic ablation may be implicated in the lower amount of JR using this technique.…”

Section: Catheter Stabilitymentioning

confidence: 99%

Slow Pathway Radiofrequency Ablation in Patients with AVNRT: Junctional Rhythm is Less Frequent during Magnetic Navigation Ablation Than with the Conventional Technique

Ricard

Laţcu

Yaici

et al. 2010

Pacing and Clinical Electrophysiology

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Introduction:The occurrence of accelerated junctional rhythm (JR) during radiofrequency ablation of the slow pathway in patients with atrioventricular nodal reentrant tachycardia (AVNRT) is frequent. The aim of the present study was to compare the occurrence of JR during magnetic remote catheter ablation to the conventional manual ablation. Methods and Results: Twenty six patients (males: seven; age: 51 ± 15 years) underwent slow pathway ablation with magnetic navigation (MN) system (Niobe, Stereotaxis Inc., St. Louis, MO, USA) and were compared to a control group of 11 patients (males: three; age: 53 ± 16 years) treated with conventional manual ablation. A 4-mm nonirrigated tip catheter was used in both groups with a maximum of 30 W and 60 • C. Acute success was obtained in all patients. In the MN group, three patients out of 24 had no junctional beat (JB) at all and seven patients had 10 or less JB. In contrast, in the conventional group no patient had less than 10 JB. The mean number of JB in the MN group was 66 ± 94.9 (0-410) and 200 ± 243.1 (43-914) in the control group (P = 0.019). In the MN group one patient had a first-degree atrioventricular block. No other complication occurred.Conclusions: Magnetic remote catheter ablation of AVNRT is effective and is associated with less JB than the manual conventional technique. Therefore, JB may not be considered as a mandatory indicator for successful AVNRT ablation with MN system. (PACE 2010; 33:11-15) ablation, SVT, new technology

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Optimal target temperature for slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia

Haghjoo

Arya

Heidari

et al. 2006

J Interv Card Electrophysiol

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The Response of the Slow Atrioventricular Nodal Pathway to Temperature

Cited by 4 publications

References 28 publications

Electroanatomically estimated length of slow pathway in atrioventricular nodal reentrant tachycardia

Electroanatomically estimated length of slow pathway in atrioventricular nodal reentrant tachycardia

Slow Pathway Radiofrequency Ablation in Patients with AVNRT: Junctional Rhythm is Less Frequent during Magnetic Navigation Ablation Than with the Conventional Technique

Optimal target temperature for slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia

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