tailieunhanh - Ebook Catheter ablation of cardiac arrhythmias (2nd edition): Part 2

(BQ) Part 2 the book "Catheter ablation of cardiac arrhythmias" presents the following contents: Ablation of atrioventricular nodal reentrant tachycardia and variants, catheter ablation of atrioventricular nodal reentrant tachycardia and the atrioventricular junction, catheter ablation of accessory atrioventricular connections,. | 19 Ablation of Atrioventricular Nodal Reentrant Tachycardia and Variants Mario D. Gonzalez Javier E. Banchs and Jaime Rivera Key Points Mechanism of atrioventricular nodal reentrant tachycardia AVNRT is reentry involving fast and slow atrioventricular AV nodal pathways. The typical slow-fast form of AVNRT is diagnosed by the presence of a long atrium-His bundle AH interval 180 milliseconds during tachycardia with the earliest retrograde atrial activation localized at the level of the superior part of the triangle of Koch just behind the tendon of Todaro fast pathway or anterior approach to the AV node . The fast-slow variant has a short AH interval during tachycardia 180 milliseconds and early retrograde atrial activation is localized near the coronary sinus CS ostium or in the proximal portion of the CS. The slow-slow variant has a long AH interval 180 milliseconds with early retrograde atrial activation near the coronary sinus CS ostium or in the proximal portion of the CS similar to the fast-slow form of AVNRT. The left-sided variant is similar to the slow-fast type but slow pathway conduction cannot be eliminated from the right atrium or proximal CS. The ablation target for all variants is the antegrade or retrograde slow pathway. Catheter navigation systems are useful to label sites of interest. Electroanatomic mapping systems are optional and cryoablation may be used for selected cases. The acute success rate is almost 100 with a 1 to 2 rate of recurrence. The rate of complications AV block is or less. Atrioventricular nodal reentrant tachycardia AVRNT is the most common form of regular supraventricular It occurs more frequently in women than in men and the initial episode of tachycardia tends to occur at an older age than in patients with atrioventricular reentrant Although AVNRT can have a benign course it can also result in disabling symptoms especially in elderly patients. Patients frequently complain of regular rapid .

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