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Turan T, Hidayet Ş, Tunçez A, Sertdemir AL, Deveci B, Celik IE, Kara M, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. An interesting response to His-synchronous ventricular stimulation: What is the mechanism of this supraventricular tachycardia?". J Cardiovasc Electrophysiol 2022; 33:1051-1054. [PMID: 35304936 DOI: 10.1111/jce.15450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 11/28/2022]
Abstract
Inappropriate therapies are frequent in patients with ICDs and are associated with adverse outcomes, including increased mortality. Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common reentrant narrow complex tachycardia and a cause of inappropriate therapies in these patients. The differential diagnosis of narrow QRS complex tachycardia with ventriculoatrial (VA) dissociation or variable block to the atrium is a pivotal role to avoid inappropriate ICD implantation or then shock therapies. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Turhan Turan
- Health Sciences University, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Şiho Hidayet
- Inonu University, Department of Cardiology, Malatya, Turkey
| | | | - Ahmet Lutfu Sertdemir
- Necmettin Erbakan University Meram Medical Faculty, Department of Cardiology, Konya, Turkey
| | - Bulent Deveci
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ibrahim Etem Celik
- Health Sciences University, Ankara Education and Research Hospital, Department of Cardiology; Ankara, Turkey
| | - Meryem Kara
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ahmet Korkmaz
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ozcan Ozeke
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Serkan Cay
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Firat Ozcan
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- İstanbul Medipol University, Department of Cardiology, İstanbul, Turkey
| | - Serkan Topaloglu
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
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Mukherjee RK, Sohal M, Shanmugam N, Pearse S, Jouhra F. Successful Identification of and Discrimination Between Atrial and Ventricular Arrhythmia with the Aid of Pacing and Defibrillator Devices. Arrhythm Electrophysiol Rev 2021; 10:235-240. [PMID: 35106174 PMCID: PMC8785083 DOI: 10.15420/aer.2021.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 10/25/2021] [Indexed: 11/15/2022] Open
Abstract
The presence of supraventricular tachycardia is the leading cause of inappropriate shock in ICD recipients, and it can be a significant cause of morbidity, psychological distress and worsened clinical outcome. Modern pacing and ICD systems offer a number of discriminators that are integrated into algorithms to differentiate sustained ventricular tachycardia from supraventricular tachycardia. These algorithms can be adapted and optimised for each individual patient to ensure that only those arrhythmias that need treatment through the use of an ICD, are actually treated. This review summarises the single- and dual-chamber discriminators that can be used in the detection and classification of tachyarrhythmias.
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Affiliation(s)
- Rahul K. Mukherjee
- Department of Cardiology, St George’s University Hospital NHS Foundation Trust, London, UK
- Division of Imaging Sciences and Biomedical Engineering, St Thomas’ Hospital, King’s College London, UK
| | - Manav Sohal
- Department of Cardiology, St George’s University Hospital NHS Foundation Trust, London, UK
| | - Nesan Shanmugam
- Department of Cardiology, St George’s University Hospital NHS Foundation Trust, London, UK
| | - Simon Pearse
- Department of Cardiology, Kingston Hospital, London, UK
| | - Fadi Jouhra
- Department of Cardiology, St George’s University Hospital NHS Foundation Trust, London, UK
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Brugada J, Katritsis DG, Arbelo E, Arribas F, Bax JJ, Blomström-Lundqvist C, Calkins H, Corrado D, Deftereos SG, Diller GP, Gomez-Doblas JJ, Gorenek B, Grace A, Ho SY, Kaski JC, Kuck KH, Lambiase PD, Sacher F, Sarquella-Brugada G, Suwalski P, Zaza A. 2019 ESC Guidelines for the management of patients with supraventricular tachycardiaThe Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J 2021; 41:655-720. [PMID: 31504425 DOI: 10.1093/eurheartj/ehz467] [Citation(s) in RCA: 522] [Impact Index Per Article: 174.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Makker P, Saleh M, Vaishnav AS, Coleman KM, Beldner S, Ismail H, Sharma N, Jadonath R, Goldner B, Mitra R, Epstein L, John R, Mountantonakis SE. Clinical predictors of heart block during atrioventricular nodal reentrant tachycardia ablation: A multicenter 18-year experience. J Cardiovasc Electrophysiol 2021; 32:1658-1664. [PMID: 33844364 DOI: 10.1111/jce.15037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Catheter ablation is considered the first-line treatment of symptomatic atrioventricular nodal reentrant tachycardia (AVNRT). It has been associated with a risk of heart block (HB) requiring a pacemaker. This study aims to determine potential clinical predictors of complete heart block as a result AVNRT ablation. METHODS Consecutive patients undergoing catheter ablation for AVNRT from January 2001 to June 2019 at two tertiary hospitals were included. We defined ablation-related HB as the unscheduled implantation of pacemaker within a month of the index procedure. Use of electroanatomic mapping (EAM), operator experience, inpatient status, age, sex, fluoroscopy time, baseline PR interval, and baseline HV interval was included in univariate and multivariate models to predict HB post ablation. RESULTS In 1708 patients (56.4 ± 17.0 years, 61% females), acute procedural success was 97.1%. The overall incidence of HB was 1.3%. Multivariate analysis showed that age more than 70 (odds ratio [OR] 7.907, p ≤ .001, confidence interval [CI] 2.759-22.666), baseline PR ≥ 190 ms (OR 2.867, p = .026, CI 1.135-7.239) and no use of EAM (OR 0.306, p = .037, CI 0.101-0.032) were independent predictors of HB. CONCLUSION Although the incidence of HB post AVNRT ablation is generally low, patients can be further stratified using three simple predictors.
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Affiliation(s)
- Parth Makker
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Moussa Saleh
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Aditi S Vaishnav
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Kristie M Coleman
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Stuart Beldner
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Haisam Ismail
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Nikhil Sharma
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Ram Jadonath
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Bruce Goldner
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Raman Mitra
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Laurence Epstein
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
| | - Roy John
- Department of Cardiac Electrophysiology, Northwell Health, New York, New York, USA
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Kumar SK, Thomas GR, Singh SM. ATP - A friend with benefits. J Electrocardiol 2021; 65:102-104. [PMID: 33588256 DOI: 10.1016/j.jelectrocard.2021.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 11/15/2022]
Abstract
Anti-tachycardia pacing (ATP) has gained widespread acceptance to treat ventricular tachyarrhythmias and prevent implantable defibrillator shocks. A 63-year-old lady with nonischemic cardiomyopathy underwent insertion of a primary prevention biventricular implantable cardioverter defibrillator (BIV-ICD). Post implant she was found to have recurrent episodes of atrioventricular nodal re-entry tachycardia (AVNRT) based on device electrograms. In this report, we describe the use of anti-tachycardia pacing to manage this tachycardia.
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Affiliation(s)
- Sharath K Kumar
- Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Garry R Thomas
- Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Sheldon M Singh
- Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
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Katritsis DG. Catheter Ablation of Atrioventricular Nodal Re-entrant Tachycardia: Facts and Fiction. Arrhythm Electrophysiol Rev 2018; 7:230-231. [PMID: 30588309 PMCID: PMC6304791 DOI: 10.15420/aer.2018.7.4.eo1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 10/24/2018] [Indexed: 11/04/2022] Open
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Katritsis DG, Boriani G, Cosio FG, Hindricks G, Jaïs P, Josephson ME, Keegan R, Kim YH, Knight BP, Kuck KH, Lane DA, Lip GYH, Malmborg H, Oral H, Pappone C, Themistoclakis S, Wood KA, Blomström-Lundqvist C, Gorenek B, Dagres N, Dan GA, Vos MA, Kudaiberdieva G, Crijns H, Roberts-Thomson K, Lin YJ, Vanegas D, Caorsi WR, Cronin E, Rickard J. European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardiaca y Electrofisiologia (SOLAECE). Europace 2018; 19:465-511. [PMID: 27856540 DOI: 10.1093/europace/euw301] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Demosthenes G Katritsis
- Athens Euroclinic, Athens, Greece; and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Giuseppe Boriani
- Cardiology Department, Modena University Hospital, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Pierre Jaïs
- University of Bordeaux, CHU Bordeaux, LIRYC, France
| | | | - Roberto Keegan
- Hospital Privado del Sur y Hospital Español, Bahia Blanca, Argentina
| | - Young-Hoon Kim
- Korea University Medical Center, Seoul, Republic of Korea
| | | | | | - Deirdre A Lane
- Asklepios Hospital St Georg, Hamburg, Germany.,University of Birmingham Institute of Cardiovascular Science, City Hospital, Birmingham, UK; and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Gregory Y H Lip
- University of Birmingham Institute of Cardiovascular Science, City Hospital, Birmingham, UK; and Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Helena Malmborg
- Department of Cardiology and Medical Science, Uppsala University, Uppsala, Sweden
| | - Hakan Oral
- University of Michigan, Ann Arbor, MI, USA
| | - Carlo Pappone
- IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | | | | | - Bulent Gorenek
- Cardiology Department, Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | - Gheorge-Andrei Dan
- Colentina University Hospital, 'Carol Davila' University of Medicine, Bucharest, Romania
| | - Marc A Vos
- Department of Medical Physiology, Division Heart and Lungs, Umc Utrecht, The Netherlands
| | | | - Harry Crijns
- Mastricht University Medical Centre, Cardiology & CARIM, The Netherlands
| | | | | | - Diego Vanegas
- Hospital Militar Central - Unidad de Electrofisiologìa - FUNDARRITMIA, Bogotà, Colombia
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Burri H. Atrioventricular 1:1 tachycardia effectively terminated by antitachycardia pacing : What is your diagnosis? Herzschrittmacherther Elektrophysiol 2016; 27:244-248. [PMID: 27459976 DOI: 10.1007/s00399-016-0444-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
This case describes a tachycardia with a 1:1 atrioventricular relationship that was effectively terminated with antitachycardia pacing by the implantable cardioverter defibrillator. The differential diagnosis and clues that allow the reader to establish the correct diagnosis are discussed. The case also serves to analyse technical features of Boston Scientific dual-chamber defibrillators.
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Affiliation(s)
- Haran Burri
- Cardiology Department, University Hospital of Geneva, Rue Gabrielle Perret Gentil 4, 1211, Geneva, Switzerland.
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