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Related Experiment Videos

Accessory pathway reciprocating tachycardia

O A Obel1, A J Camm

  • 1Department of Cardiological Sciences, St George's Hospital Medical School, London, U.K.

European Heart Journal
|August 26, 1998
PubMed
Summary
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Accessory pathways can cause atrioventricular re-entrant tachycardia (AVRT), a rapid heart rhythm. Management includes medication and catheter ablation, with ablation offering a potential cure for AVRT.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Arrhythmias

Background:

  • Accessory pathways (APs) are abnormal electrical connections that can lead to atrioventricular re-entrant tachycardia (AVRT).
  • AVRT, particularly orthodromic AVRT, is a common supraventricular tachycardia involving antegrade conduction via the normal system and retrograde conduction via the AP.
  • Rapid ventricular rates during atrial fibrillation conducted via an AP pose a risk of ventricular fibrillation and cardiac arrest.

Purpose of the Study:

  • To review the anatomical and physiological basis of AVRT pathogenesis.
  • To discuss the acute and long-term management strategies for patients with AVRT.
  • To highlight the diagnostic and therapeutic advancements in managing AVRT.

Main Methods:

  • Review of literature on AVRT pathophysiology, diagnosis, and management.

Related Experiment Videos

  • Discussion of electrocardiogram (ECG) findings, including pre-excitation and broad complex tachycardias.
  • Emphasis on the role of electrophysiology studies and catheter ablation in diagnosis and treatment.

    • Main Results:

    • Accessory pathways exhibit non-decremental conduction, often faster than normal AV conduction, and can be identified by ECG pre-excitation.
    • Adenosine is effective for diagnosing and terminating AVRT, and for unmasking latent pre-excitation.
    • Catheter ablation has revolutionized AVRT management, offering a highly effective cure with low complication rates, though septal pathways remain challenging.

    Conclusions:

    • AVRT management has significantly improved with catheter ablation, providing a curative option for many patients.
    • While drug therapy offers temporary control, catheter ablation is the preferred definitive treatment for symptomatic AVRT.
    • Ongoing challenges include managing complex pathway locations and ensuring optimal patient selection for ablation.