In:
Pacing and Clinical Electrophysiology, Wiley, Vol. 42, No. 2 ( 2019-02), p. 267-274
Kurzfassung:
Low‐dose adenosine triphosphate (LD‐ATP) is useful for diagnosing ATP‐sensitive atrial tachycardia. However, the clinical implications of the sensitivity of LD‐ATP in atrioventricular nodal reentrant tachycardia (AVNRT) still remain unknown. This study aimed to evaluate the mechanism of LD‐ATP sensitivity in slow‐fast AVNRT. Methods We estimated the sensitivity of LD‐ATP in slow‐fast AVNRT by a 2‐4‐mg ATP intravenous injection during the tachycardia. We evaluated the atrial‐His (A‐H) interval, tachycardia termination mode, prevalence of a lower common pathway (LCP), and successful ablation site in slow‐fast AVNRT with LD‐ATP sensitivity. LCPs were defined as His‐atrial interval differences of at least 5 ms between that during ventricular pacing at the tachycardia cycle length and that during the tachycardia. Results Twenty‐eight patients (mean age = 58 ± 11 years old, 18 females) with slow‐fast AVNRT, who underwent catheter ablation of the antegrade slow pathway, were enrolled. Seventeen of 28 (61%) patients had LD‐ATP sensitivity defined as termination of the tachycardia and/or a prolongation of the A‐H interval of over 30 ms after an LD‐ATP injection. The patients with LD‐ATP sensitivity had a significantly higher prevalence of an LCP than those without (15/17 vs0/11, P 〈 0.0001). The successful ablation site in the LD‐ATP sensitive group was significantly closer to the His bundle area than that in the LD‐ATP nonsensitive group (13.3 ± 3.8 vs 20.5 ± 5.4 mm; distance to His bundle area in the left anterior oblique fluoroscopic view, P 〈 0.0001). Conclusions LD‐ATP sensitivity in slow‐fast AVNRT may suggest the existence of an LCP. The successful ablation site in patients with LD‐ATP sensitivity could be closer to the His bundle region.
Materialart:
Online-Ressource
ISSN:
0147-8389
,
1540-8159
DOI:
10.1111/pace.2019.42.issue-2
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2019
ZDB Id:
2037547-5
