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Modifications of the Langendorff Method for Simultaneous Isolation of Atrial and Ventricular Myocytes from Adult Mice
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Elongated ascending aorta predicts a short distance between his-bundle potential recording site and coronary sinus

Yuichi Momose1, Kyoko Soejima1, Akiko Ueda1

  • 1Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan.

Journal of Arrhythmia
|August 3, 2017
PubMed

Insights

Aortic unfolding predicts a smaller triangle of Koch (TOK) during atrioventricular nodal reentrant tachycardia (AVNRT) ablation. This finding helps electrophysiologists maintain safe distances and avoid atrioventricular block.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Imaging

Background:

  • Catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) requires safe distances from the His recording site to prevent atrioventricular block.
  • A small triangle of Koch (TOK) poses challenges due to the proximity of the His bundle to the coronary sinus ostium.

Purpose of the Study:

  • To identify parameters that predict a small triangle of Koch (TOK).
  • To test these predictive parameters in patients undergoing AVNRT catheter ablation.

Main Methods:

  • Utilized a 3D electroanatomical mapping system (EAM) with CT merge in 28 patients undergoing atrial fibrillation ablation.
  • Measured the His-CS distance (His-CSd) on EAM and evaluated aortic unfolding, aortic length, left ventricular dimensions, and Valsalva sinus size.
  • Tested identified parameters as predictors for small TOK in AVNRT ablation patients.

Main Results:

  • A smaller TOK was associated with longer aortic length (r = -0.70, p<0.01) and larger left ventricular end-systolic dimension (LVDs) (r = -0.51, p<0.01).
  • Aortic unfolding was identified as a significant predictor of a smaller TOK in patients with AVNRT.

Conclusions:

  • A longer aorta, larger LVDs, and aortic unfolding are associated with a smaller TOK.
  • Aortic unfolding is a key predictor for identifying a smaller TOK in AVNRT ablation procedures, aiding in safer catheter interventions.
Abstract

Keywords:
AV nodal reentrant tachycardiaAortic unfoldingTriangle of Koch

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