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Chapter-17 Atrioventricular Nodal Reentrant Tachycardia: Classification, Electrophysiological Features, and Ablation

BOOK TITLE: Practical Cardiac Electrophysiology

Author
1. Katritsis Demosthenes G
2. Josephson Mark E
ISBN
9789386056795
DOI
10.5005/jp/books/13028_18
Edition
1/e
Publishing Year
2017
Pages
8
Author Affiliations
1. Athens Euroclinic, Athens, Greece, Athens Euroclinic, Athens, Greece; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
2. Beth Israel Deaconess Medical Center; Harvard Medical School; Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Boston, MA, USA
Chapter keywords
Atrioventricular nodal reentrant tachycardia, AVNRT, typical AVNRT, atypical AVNRT, lower common pathway, ablation

Abstract

Atrioventricular nodal reentrant tachycardia (AVNRT) denotes reentry in the area of the atrioventricular (AV) node, and although several models have been proposed to explain the mechanism of the arrhythmia in the context of the complex anatomy of the AV node and its atrial extensions, the actual circuit of the arrhythmia remains elusive. AVNRT should be classified either as typical or atypical. Earliest atrial retrograde activation, upper and lower common pathways and relative AH/HA intervals are the different electrophysiological features of AVNRT. When the diagnosis of AVNRT is established, ablation should be only directed towards the anatomic position of the slow pathway. If right septal attempts are unsuccessful, the left septal side should be tried. Ablation targeting earliest atrial activation sites during typical AVNRT or the fast pathway in general for any kind of typical or atypical AVNRT, are not justified.

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