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Ultra-high-density mapping for safe and effective typical atrioventricular nodal reentrant tachycardia ablation

Sakamoto, Yusuke Osanai, Hiroyuki 名古屋大学

2023.11

概要

Catheter ablation for typical atrioventricular nodal reentrant tachycardia (AVNRT) is an
established effective treatment.1 Conventional target sites for ablation include the slow potential
of the slow pathway (SP)2,3 or a specific anatomical site.4 Recently, a detailed analysis of
the excitatory propagation of the Koch’s triangle in typical AVNRT was conducted using the
Rhythmia electroanatomic mapping system,5 with successful outcomes of ablation performed at
the recording site of Jackman potentials (JPs), characterized by dull and spiky potentials on
detailed mapping of the Koch’s triangle using the same system.6 Herein, we report our use of
ultra-high-density (UHD) mapping to identify the ablation optimal site for the treatment of typical
slow-fast AVNRT, diagnosed by electrophysiological study and established criteria.7
Received: November 24, 2022; accepted: January 18, 2023
Corresponding Author: Yusuke Sakamoto, MD, PhD
Department of Cardiology, Tosei General Hospital, 160 Nishi-Oiwake-cho, Seto 489-8642, Japan
Tel: +81-561-82-5101, Fax: +81-561-82-9139, E-mail: aimnaz_sheena@yahoo.co.jp
844 ...

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参考文献

1 Katritsis DG, Zografos T, Katritsis GD, et al. Catheter ablation vs. antiarrhythmic drug therapy in patients

with symptomatic atrioventricular nodal re-entrant tachycardia: a randomized, controlled trial. Europace.

2017;19(4):602–606. doi:10.1093/europace/euw064.

2 Jackman WM, Beckman KJ, McClelland JH, et al. Treatment of supraventricular tachycardia due to

atrioventricular nodal reentry by radiofrequency catheter ablation of slow-pathway conduction. N Engl J

Med. 1992;327(5):313–318. doi:10.1056/NEJM199207303270504.

3 Haissaguerre M, Gaita F, Fischer B, et al. Elimination of atrioventricular nodal reentrant tachycardia using

discrete slow potentials to guide application of radiofrequency energy. Circulation. 1992;85(6):2162–2175.

doi:10.1161/01.cir.85.6.2162.

4 Nogami A, Kurita T, Abe H, et al. CORRIGENDUM: JCS/JHRS 2019 guideline on non-pharmacotherapy

of cardiac arrhythmias. Circ J. 2021;85(9):1692–1700. doi:10.1253/circj.CJ-66-0196.

5 Chua K, Upadhyay GA, Lee E, et al. High-resolution mapping of the triangle of Koch: Spatial heterogeneity

of fast pathway atrionodal connections. Heart Rhythm. 2018;15(3):421–429. doi:10.1016/j.hrthm.2017.10.030.

6 Pandozi C, Lavalle C, Bongiorni MG, et al. High-density mapping of Koch’s triangle during sinus rhythm

and typical AV nodal reentrant tachycardia: new insight. J Interv Card Electrophysiol. 2021;61(3):487–497.

doi:10.1007/s10840-020-00841-8.

7 Knight BP, Ebinger M, Oral H, et al. Diagnostic value of tachycardia features and pacing maneuvers

during paroxysmal supraventricular tachycardia. J Am Coll Cardiol. 2000;36(2):574–582. doi:10.1016/

s0735-1097(00)00770-1.

8 Nakagawa H, Jackman WM. Catheter ablation of paroxysmal supraventricular tachycardia. Circulation.

2007;116(21):2465–2478. doi:10.1161/CIRCULATIONAHA.106.655746.

References End

Nagoya J. Med. Sci. 85. 844–851, 2023

851

doi:10.18999/nagjms.85.4.844

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