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Effect of atrial activation site on AV nodal conduction time.

Effect of atrial activation site on AV nodal conduction time.

 

DOI:
http://dx.doi.org/10.5031/v1i2.RIA10181

Id:
v1i2.RIA10181

Idioma del manuscrito:
English

País:
Mexico

Categoría (seleccionar una categoría apropiada para el envío) :
Artículos Originales

Palabras clave:
Ablación, Macro-reentrada, Taquicardia supraventricular

Autores y títulos (Ejemplo: Fernandes C., MD, PhD, etc):
Molina L. MD., Pérez D. MD:, Gandoy W. MD.

Laboratorio de Electrofisiología Clínica de la UNAM. Hospital General de México, Juventino Rosas 70-202, México DF
lmolina@unam.mx

 

Resumen en Español o Portugués

Background: During supraventricular tachycardia (SVT) it is common to observe heart rates of over 230 /min from the beginning of the paroxysm, whereas pacing the right atrium is usual to see type I AV block at rates as low as 170 /min. Hypothesis: Atrioventricular (AV) nodal conduction is faster during left atrial pacing than from the right, suggesting that the activation site of the AV node affects its conduction properties. Methods and results: In twenty consecutive patients after successful RF ablation of a SVT, AV nodal conduction was analyzed by alternatively pacing the right atrium and distal coronary sinus. To emulate the beginning of the SVT, we applied a conditioning drive train of 10 S1-S1 followed by a sequence of six premature stimuli (S2-S7). Results: We studied 20 consecutive patients, 17 with accessory pathways and 3 with AV nodal reentrant tachycardia (AVNRT). During the S2-S7 stimuli, the mean Sn-H interval was 220 ±37 ms pacing from the right, versus 170 ±35 ms from the left (p< 0.0003) a 29% difference. Conclusions: AV nodal conduction is 29% faster if the impulse arrives from the left atrium as compared to the right atrium.

Resumen en Inglés

Background: During supraventricular tachycardia (SVT) it is common to observe heart rates of over 230 /min from the beginning of the paroxysm, whereas pacing the right atrium is usual to see type I AV block at rates as low as 170 /min. Hypothesis: Atrioventricular (AV) nodal conduction is faster during left atrial pacing than from the right, suggesting that the activation site of the AV node affects its conduction properties. Methods and results: In twenty consecutive patients after successful RF ablation of a SVT, AV nodal conduction was analyzed by alternatively pacing the right atrium and distal coronary sinus. To emulate the beginning of the SVT, we applied a conditioning drive train of 10 S1-S1 followed by a sequence of six premature stimuli (S2-S7). Results: We studied 20 consecutive patients, 17 with accessory pathways and 3 with AV nodal reentrant tachycardia (AVNRT). During the S2-S7 stimuli, the mean Sn-H interval was 220 ±37 ms pacing from the right, versus 170 ±35 ms from the left (p< 0.0003) a 29% difference. Conclusions: AV nodal conduction is 29% faster if the impulse arrives from the left atrium as compared to the right atrium.

 

Contenido

Effect of atrial activation site on AV nodal conduction time.

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