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Related Experiment Videos

Reentry within the atrioventricular node in man: a reassessment.

E L Pritchett, J J Gallagher, A G Wallace

    European Journal of Cardiology
    |February 1, 1978
    PubMed
    Summary

    Some supraventricular tachycardia patients may have hidden accessory pathways. Identifying these pathways is crucial as their ablation offers a curative treatment for the condition.

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    Area of Science:

    • Electrophysiology
    • Cardiology
    • Cardiac Arrhythmias

    Background:

    • Reentrant supraventricular tachycardia (SVT) is a common arrhythmia.
    • The atrioventricular (AV) node is a frequent site for SVT reentry.
    • Accessory pathways can also cause SVT, sometimes conducting only retrogradely.

    Purpose of the Study:

    • To investigate the electrophysiological characteristics of patients with reentrant SVT.
    • To differentiate between AV nodal reentry and accessory pathway involvement in SVT.
    • To explore the diagnostic utility of the atrial extra-stimulus (S1-S2) technique.

    Main Methods:

    • Studied 6 patients with reentrant SVT using the atrial extra-stimulus (S1-S2) technique.
    • Analyzed H1-H2 and A1-A2 interval curves to assess AV nodal refractoriness.
    • Investigated the effect of atrial pacing site on the echo zone in patients with accessory pathways.

    Main Results:

    • Three patients exhibited smooth H1-H2/A1-A2 curves, suggesting AV nodal reentry, but had retrograde-only accessory pathways.
    • Three patients showed discontinuous curves, with echo zones limited to longer AV nodal responses, and no accessory pathways were demonstrated.
    • Pacing remote from accessory pathways shifted the echo zone to shorter coupling intervals.

    Conclusions:

    • Some cases of presumed AV nodal reentry may involve accessory pathways conducting only retrogradely.
    • The S1-S2 technique can help identify these previously unrecognized accessory pathways.
    • Recognition and ablation of these accessory pathways represent a curative treatment for SVT.

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