Patient with Atrioventricular Node Reentrant Tachycardia with Eccentric Retrograde Left-sided Activation Treatment with Radiofrequency Catheter Ablation

Koichi SAKABE; Tetsuzo WAKATSUKI; Hiroyuki FUJINAGA; Yoshifumi OISHI; Jiro IKATA; Toshihiro TOYOSHIMA; Norikazu HIURA; Akiyoshi NISHIKADO; Takashi OKI; Susumu ITO

doi:10.1536/jhj.41.227

Koichi SAKABE, Tetsuzo WAKATSUKI, Hiroyuki FUJINAGA, Yoshifumi OISHI, Jiro IKATA, Toshihiro TOYOSHIMA, Norikazu HIURA, Akiyoshi NISHIKADO, Takashi OKI, Susumu ITO

Author information

Koichi SAKABE
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Tetsuzo WAKATSUKI
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Hiroyuki FUJINAGA
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Yoshifumi OISHI
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Jiro IKATA
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Toshihiro TOYOSHIMA
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Norikazu HIURA
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Akiyoshi NISHIKADO
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Takashi OKI
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.
Susumu ITO
Second Department of Internal Medicine, School of Medicine, the University of Tokushima, Tokushima, Japan.

Keywords: Atrioventricular node reentrant tachycardia, Eccentric retrograde left-sided atrial activation, Triple atrioventricular nodal pathways, Radio frequency catheter ablation

JOURNAL FREE ACCESS

2000 Volume 41 Issue 2 Pages 227-234

DOI https://doi.org/10.1536/jhj.41.227

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Abstract

We describe a patient with supraventricular tachycardia with triple atrioventricular (AV) node pathway physiology. A discontinuous curve was present in the antegrade AV nodal function curves. During right ventricular pacing, the earliest retrograde atrial activation was recorded at the left-sided coronary sinus electrode. The retrograde ventricular-atrial interval was long and had decremental conduction. We induced a slow-slow AV node reentrant tachycardia (AVNRT) with eccentric retrograde left-sided activation. After slow pathway ablation, dual AV nodal pathway physiology was present. AVNRT with eccentric retrograde left-sided activation is relatively rare, and our findings suggest that eccentric retrograde left-sided atrial inputs consist partially of a slow pathway and disappear with slow pathway ablation. (Jpn Heart J 2000; 41: 227-234)

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