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Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia

Typical atrio-ventricular nodal re-entrant tachycardia (AVNRT) can occasionally remain easily inducible after slow pathway (SP) modification in lower Triangle of Koch (TOK). Analysis of resetting response by delivering atrial premature depolarizations (APD) from various sites (TOK, right atrium, cor...

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Detalles Bibliográficos
Autores principales: Bera, Debabrata, Sarkar, Rakesh, Joshi, Radhey Shyam, Kar, Ayan, Mukherjee, Sanjeev S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691773/
https://www.ncbi.nlm.nih.gov/pubmed/32896609
http://dx.doi.org/10.1016/j.ipej.2020.08.007
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author Bera, Debabrata
Sarkar, Rakesh
Joshi, Radhey Shyam
Kar, Ayan
Mukherjee, Sanjeev S.
author_facet Bera, Debabrata
Sarkar, Rakesh
Joshi, Radhey Shyam
Kar, Ayan
Mukherjee, Sanjeev S.
author_sort Bera, Debabrata
collection PubMed
description Typical atrio-ventricular nodal re-entrant tachycardia (AVNRT) can occasionally remain easily inducible after slow pathway (SP) modification in lower Triangle of Koch (TOK). Analysis of resetting response by delivering atrial premature depolarizations (APD) from various sites (TOK, right atrium, coronary sinus and left atrium) can pin-point the culprit SP serving as the antegrade limb of the tachycardia circuit. However, the maneuver is under-utilized by most centers. We describe a case where anatomical SP modification in TOK failed to cure the arrhythmia. The resetting maneuver performed subsequently, helped us to rule out leftward inferior extension of SP and suggested right inferior SP as essential part of AVNRT circuit. Further ablation was performed at M1-M2 region (on the right side) to achieve success.
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spelling pubmed-76917732020-12-07 Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia Bera, Debabrata Sarkar, Rakesh Joshi, Radhey Shyam Kar, Ayan Mukherjee, Sanjeev S. Indian Pacing Electrophysiol J Case Report Typical atrio-ventricular nodal re-entrant tachycardia (AVNRT) can occasionally remain easily inducible after slow pathway (SP) modification in lower Triangle of Koch (TOK). Analysis of resetting response by delivering atrial premature depolarizations (APD) from various sites (TOK, right atrium, coronary sinus and left atrium) can pin-point the culprit SP serving as the antegrade limb of the tachycardia circuit. However, the maneuver is under-utilized by most centers. We describe a case where anatomical SP modification in TOK failed to cure the arrhythmia. The resetting maneuver performed subsequently, helped us to rule out leftward inferior extension of SP and suggested right inferior SP as essential part of AVNRT circuit. Further ablation was performed at M1-M2 region (on the right side) to achieve success. Elsevier 2020-09-05 /pmc/articles/PMC7691773/ /pubmed/32896609 http://dx.doi.org/10.1016/j.ipej.2020.08.007 Text en © 2020 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Bera, Debabrata
Sarkar, Rakesh
Joshi, Radhey Shyam
Kar, Ayan
Mukherjee, Sanjeev S.
Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
title Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
title_full Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
title_fullStr Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
title_full_unstemmed Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
title_short Reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
title_sort reappraisal of resetting response to locate the antegrade pathway in slow-fast atrio-ventricular nodal re-entrant tachycardia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7691773/
https://www.ncbi.nlm.nih.gov/pubmed/32896609
http://dx.doi.org/10.1016/j.ipej.2020.08.007
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