Multiple Shifts of the Earliest Retrograde Atrial Activation Site Along the Tricuspid Annulus During the Fast-Slow Form of Atrioventricular Nodal Reentrant Tachycardia by Radiofrequency Modification
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- Okada Masato
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Tanaka Koji
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Matsunaga-Lee Yasuharu
- Department of Cardiology, Japan Community Healthcare Organization (JCHO) Hoshigaoka Medical Center
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- Ninomiya Yuichi
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Hirao Yuko
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Oka Takafumi
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Tanaka Nobuaki
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Inoue Hiroyuki
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Iwakura Katsuomi
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Fujii Kenshi
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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- Inoue Koichi
- Cardiovascular Center, Sakurabashi-Watanabe Hospital
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説明
<p>A 70-year-old woman was admitted for treatment of supraventricular tachycardia. Ventriculoatrial conduction was revealed through programmed ventricular stimulation; the coronary sinus ostium (CSos) was the earliest atrial activation site. The fast-slow forms of atrioventricular nodal reentrant tachycardia (AVNRT) were induced by ventricular extra-stimuli. During tachycardia, the earliest atrial activation site was located at the bottom of CSos. Radiofrequency (RF) energy application to this site resulted in the delay of local electrical potential, prolongation of tachycardia cycle length, and a shift of the earliest retrograde activation site to the roof of CSos. Subsequent ablation induced a similar shift to the inferior tricuspid annulus and to the right posterior septum. Finally, RF energy application to the right posterior septum resulted in the termination of tachycardia, which was not induced afterward. Multiple shifts in the earliest retrograde atrial activation site along the tricuspid annulus after each slow pathway ablation suggested that annular tissue plays a substantial role as a substrate for AVNRT.</p>
収録刊行物
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- International Heart Journal
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International Heart Journal 60 (3), 761-767, 2019-05-30
一般社団法人 インターナショナル・ハート・ジャーナル刊行会