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Electroanatomic Mapping of the Atrioventricular Node and Right Inferior Nodal Extension: Insights from a Case Series

George Katritsis1, George Stavropoulos2, Nikolaos Fragakis2

  • 1Royal Brompton and Harefield Hospital NHS Trust London, UK.

Arrhythmia & Electrophysiology Review
|May 9, 2025
PubMed

Insights

Catheter ablation for atrioventricular nodal re-entrant tachycardia can be guided by electroanatomic mapping. This study shows that the atrioventricular node and its right inferior extension can be successfully mapped in the electrophysiology lab.

Area of Science:

  • Electrophysiology
  • Cardiology
  • Medical instrumentation

Background:

  • Typical atrioventricular nodal re-entrant tachycardia (AVNRT) is a common cause of supraventricular tachycardia.
  • Catheter ablation is a curative treatment for AVNRT.
  • Accurate electroanatomic mapping is crucial for successful ablation outcomes.

Observation:

  • This study investigated the feasibility of mapping the atrioventricular node (AVN) and its right inferior extension in three patients undergoing AVNRT ablation.
  • An electroanatomic system capable of high-resolution bipolar and unipolar electrogram recording was utilized.
  • Sinus rhythm was the rhythm of study.

Findings:

  • Bipolar signals successfully recorded potentials from the right inferior extension area in all patients.
  • Unipolar signals enabled recording of the electrical activity of the atrioventricular node in all three participants.
  • This preliminary data supports the capability of current electrophysiology technology for detailed AVN mapping.

Implications:

  • These findings suggest that electroanatomic mapping can provide detailed insights into AVN and its extension during procedures.
  • Improved visualization of the AVN region may enhance the precision and efficacy of catheter ablation for AVNRT.
  • Further research with larger cohorts is warranted to confirm these preliminary observations.

Keywords:
Atrioventricular junctionHis bundleatrioventricular noderight inferior nodal extension

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