Syncope Management and Diagnostic Testing
Andrea Natale, Oussama M. Wazni, Kalyanam Shivkumar, Francis E. Marchlinski in Handbook of Cardiac Electrophysiology, 2020
The role of transesophageal EPS, which is similar to performing a TEE, is limited to: Screening for rapid AtrioVentricular Nodal Reentrant Tachycardia (AVNRT)AtrioVentricular Reentrant Tachycardia (AVRT) in patients with palpitations and a normal ECGEvaluation of SND in syncope due to bradycardiaRisk evaluation in accessory pathways
Natural Deaths
John M. Wayne, Cynthia A. Schandl, S. Erin Presnell in Forensic Pathology Review, 2017
Answer A is incorrect. Wolff–Parkinson–White syndrome is characterized by an abnormal electrical reentrant pathway between the atria and ventricles. The normally conducted signal from the atrioventricular (AV) node to the ventricles is redirected back to the atria with resultant atrial contraction and re-stimulation of the AV node. Tachycardia is a common finding (also termed atrioventricular reentrant tachycardia or AVRT).
Fetal echocardiography
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
Mechanistically, almost 90% of SVT in fetuses are due to atrioventricular reentrant tachycardia via common type of accessory pathway (67). SVT can also be due to atrioventricular nodal, permanent junctional, or multiple reentrant pathways as well as due to automatic ectopic focus confined to the atrium. These types of SVTs are much less common during fetal age (67,72,73).
Association between atrial septal aneurysm and arrhythmias
Published in Scandinavian Cardiovascular Journal, 2020
Ertan Yetkin, Mehmet Ileri, Ahmet Korkmaz, Selcuk Ozturk
After getting informed consent, patients with suspected and non-documented arrhythmia either by electrocardiography or ambulatory 24-h rhythm monitoring, and patients with documented arrhythmia to identify and treat the arrhythmia were scheduled for electrophysiological study (EPS) and radiofrequency ablation. EPS was performed in the fasted state, at least 5 half-lives after discontinuation of antiarrhythmic medications. Three catheter electrodes (USCI 6F) were introduced percutaneous under fluoroscopic control into the femoral vein and positioned in the high right atrium, across the tricuspid valve for His bundle recording, and at the right ventricular apex. When an atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT) or atrial tachycardia (AT) was induced, subsequent ablation procedures were performed. The ablation itself was performed in sinus rhythm in most cases or under continuing tachycardia if required for mapping. Successful ablation was defined as the absence of reinducibility of the native tachycardia, disappearance of dual AV node physiology or the loss of the delta wave in AVRT. Subsequently, further electrophysiological testing for additional tachycardias, which could potentially have been masked by the ablated primary tachycardia, was performed.
Atrial fibrillation in young patients
Published in Expert Review of Cardiovascular Therapy, 2018
Jean-Baptiste Gourraud, Paul Khairy, Sylvia Abadir, Rafik Tadros, Julia Cadrin-Tourigny, Laurent Macle, Katia Dyrda, Blandine Mondesert, Marc Dubuc, Peter G. Guerra, Bernard Thibault, Denis Roy, Mario Talajic, Lena Rivard
AF is a common arrhythmia in older adults but, in the absence of structural heart disease is rare in pediatric, teenagers and young adult patients. Prevalence of AF has been estimated to 0.05% in patients younger than 30 years of age compared to 10% in patients older than 80. A family history of AF is more often present in young patients. Genetic testing has been disappointing and is not done in clinical practice. Management of AF in this younger population is largely extrapolated from adult studies and guidelines but is associated with the need of a specific workup. Indeed, the workup should rule out the presence of a genetic pathology, a reentrant tachycardia (atrioventricular nodal reentrant tachycardia or atrioventricular reentrant tachycardia) or predisposing factors such as obesity, alcohol or drug use or strenuous exercise. Obesity has also been linked to sleep apnea, diabetes and hypertension in this young population. Long-term practice of strenuous endurance exercise (cycling, cros-country skiing, or marathon running) has been associated with an increased risk of paroxysmal AF in otherwise healthy young adults. Sport reduction or abstinence have shown a reduction in AF episodes.
Robotic magnetic-guided catheter ablation in patients with congenital heart disease: a systematic review and pooled analysis
Published in Expert Review of Cardiovascular Therapy, 2023
Christophe Vô, Stefano Bartoletti, Karim Benali, Cecilia M Gonzalez, Blandine Mondésert, Marie-Hélène Gagnon, Katia Dyrda, Anne Fourier, Paul Khairy
Congenital heart disease was categorized into three subgroups (i.e. simple [type I]; moderate [type II], and complex [type III]) according to the classification scheme proposed by the 2018 American Heart Association/American College of Cardiology management guidelines on adult CHD [7]. Arrhythmias were classified according to their mechanisms as follows: Incisional or focal atrial tachycardias Intra-atrial reentrant tachycardia (IART) refers to tachycardias involving macro-reentrant atrial circuits that are usually bound by native anatomical structures (e.g. atrioventricular valve, IVC, or superior vena cava), prosthetic material (e.g. atrial septal patch), or scars (e.g. surgical atriotomy).Focal atrial tachycardias arise from a localized atrial site and are characterized by regular organized atrial activity [8]. The category includes automatic focal atrial tachycardias and non-automatic focal atrial tachycardia (NAFAT).Atrioventricular reentrant tachycardia (AVRT) was defined as a reentrant tachycardia involving an accessory pathway, the atrium, the atrioventricular node (or second accessory pathway), and the ventricle [8].Atrioventricular nodal reentrant tachycardia (AVNRT) was defined as a reentrant tachycardia involving two functionally distinct pathways within the atrioventricular node, most frequently referred to as ‘fast’ and ‘slow’ pathways [8].Twin AV node reentrant tachycardia was defined as a reentrant tachycardia involving two functionally distinct atrioventricular nodes.Atrial fibrillation (AF) was defined as a supraventricular arrhythmia with uncoordinated atrial activation. Electrocardiographic characteristics included: 1) irregular atrial activity, 2) absence of distinct P waves, and 3) irregular R-R intervals (when atrioventricular conduction was present) [8].
Related Knowledge Centers
- Accessory Pathway
- Arrhythmia
- Dizziness
- Palpitations
- Shortness of Breath
- Supraventricular Tachycardia
- Tachycardia
- Atrioventricular Node
- Wolff–Parkinson–White Syndrome
- Permanent Junctional Reciprocating Tachycardia
- Shortness of Breath