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• W3028840385 abstract "Abstract Background Ablation of slow‐fast atrioventricular nodal reentrant tachycardia (S/F‐AVNRT) is occasionally refractory. We hypothesized that the site of ablation for curing S/F‐AVNRT can be screened by simple differential atrial entrainment pacing (EP) from the high right atrium (HRA) and proximal coronary sinus (prox‐CS). Methods We enrolled 43 patients with S/F‐AVNRT who underwent successful differential atrial EP followed by successful ablation of slow pathway (SP) using step‐wise approach, and compared the atrio‐His (A‐H) interval at the recording of His bundle immediately after EP from the HRA [A‐H(HRA)], with the interval between atrial deflection at the prox‐CS and His bundle electrogram after EP at an identical cycle length from the prox‐CS [A‐H (prox‐CS)]. Results A typical A‐H(CS) shorter than A‐H(HRA), consistent with typical SP conduction, was observed in 39 patients (91%), and an atypical A‐H(HRA) shorter than A‐H(CS) was observed in 4 patients (9%). Successful ablation was obtained at the posteroseptum/midseptum in 32/7 patients with typical responses but only at the midseptum in all 4 patients with atypical responses ( P = .0027). The atypical responses predicted a necessity for ablation at the midseptum, with positive and negative predictive values of 100% and 82%, respectively. The mechanism of an atypical response remains unclear but may involve an anatomical variation of Koch's triangle and/or the participation of a variant of the SP, including the superior SP, over which retrograde conduction was observed more frequently in patients with atypical responses ( P = .0013). Conclusions Differential atrial EP predicts the ablation site for successfully curing S/F‐AVNRT." @default.
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• W3028840385 date "2020-05-29" @default.
• W3028840385 modified "2023-09-27" @default.
• W3028840385 title "Simple differential entrainment screens ablation strategy for slow‐fast atrioventricular nodal reentrant tachycardia" @default.
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• W3028840385 doi "https://doi.org/10.1111/pace.13946" @default.
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