Case Of Atrioventricular Reentrant Tachycardia Research Articles

Diagnostic accuracy of Apple Watch Series 6 recorded single-lead ECGs for identifying supraventricular tachyarrhythmias: a comparative analysis with invasive electrophysiological study.

The advancements in wearable technology have made the detection of arrhythmias more accessible. While smartwatches are commonly used to detect patients with atrial fibrillation, their effectiveness in the differential diagnosis of supraventricular tachycardias (SVT) lacks consensus. A study was conducted on 47 patients with documented SVTs on a 12-lead ECG. All patients in the cohort underwent electrophysiology study with induction of SVT. A 6th generation Apple Watch was used to record ECG tracings during baseline sinus rhythm and during induced SVT. Cardiology residents and attending cardiologists evaluated these recordings to diagnose the differential diagnosis of SVT. The evaluation revealed 27 cases of typical atrioventricular nodal reentrant tachycardia (AVNRT), 11 cases of atrioventricular reentrant tachycardia (AVRT), and 9 cases of atrial tachycardia/atrial flutter (AT/AFL) among the induced tachycardias. Attending physicians achieved an accuracy of 66.0 to 76.6%, and residents demonstrated accuracy rates between 68.1 and 74.5%. Interrater reliability was assessed using Fleiss's Kappa method, resulting in a moderate level of agreement between residents (Kappa = 0.465, p < 0.001, 95% CI 0.30-0.63) and attendings (Kappa = 0.519, p < 0.001, 95% CI 0.35-0.68). The overall Kappa value was 0.417 (p < 0.001, 95% CI 0.34-0.49). Smartwatch recordings demonstrate moderate feasibility in diagnosing SVT when following a pre-specified algorithm. However, this diagnostic performance was lower than the accuracy obtained from 12-lead ECG tracings when blinded to procedure outcomes.

The efficacy of radiofrequency ablation in the treatment of pediatric arrhythmia and its effects on serum IL-6 and hs-CRP.

The aim of this study was to investigate the efficacy of radiofrequency ablation in the treatment of pediatric arrhythmia and to assess the changes in serum interleukin-6 (IL-6) and hs-CRP levels after treatment. Hundred and six children with tachyarrhythmia who were admitted to Xuzhou Children's Hospital from November, 2014 to December, 2015 were recruited for study. The efficacies of radiofrequency in the treatment of different types of arrhythmia were analyzed. Successful ablation was found in 104 cases (98.11%) and recurrence was found in 7 cases (6.73%). Among 62 cases of atrioventricular reentrant tachycardia (AVRT), successful ablation was found in 60 cases (96.77%) and recurrence was found in 3 cases (4.84%). Among 33 cases of atrioventricular nodal reentrant tachycardia (AVNRT), successful ablation was found in 33 cases (100%) and recurrence was found in 2 cases (6.06%). Among 5 cases of ventricular tachycardia (VT), successful ablation was found in 5 cases (100%) and no recurrence was found. Among 4 cases of atrial tachycardia (AT), successful ablation was found in 4 cases (100%) and recurrence was found in 1 case (25%). Among 2 cases of atrial flutter (AFL), successful ablation was found in both (100%) and recurrence was found in 1 case (50%). After operation, the levels of IL-6 and hs-CRP were increased and were continually increased within 6 h after operation. The levels of IL-6 and hs-CRP at 24 h after operation were reduced but still higher than preoperative levels. The duration of radiofrequency and ablation energy were positively correlated with the levels of IL-6 and hs-CRP, while the number of discharges was not significantly correlated with either. In conclusion, radiofrequency ablation is a safe and effective treatment for pediatric arrhythmia. Postoperative monitoring of IL-6 and hs-CRP levels is conducive to understanding postoperative myocardial injury and inflammatory response.

A Case of Atrioventricular Reentrant Tachycardia Via a Left Posterior Accessory Pathway Located at Adjacent to the Leftward Extension of the Atrioventricular Node

A Case of Atrioventricular Reentrant Tachycardia Via a Left Posterior Accessory Pathway Located at Adjacent to the Leftward Extension of the Atrioventricular Node

Radiofrequency catheter ablation therapy used in 123 children with drug-refractory tachycardia arrhythmias

Objective To evaluate the safety and efficacy of radiofrequency catheter ablation (RFCA) in children with tachycardia arrhythmias. Methods One hundred and twenty-three children under 3 years old with drug-refractory tachycardia underwent an interventional electrophysiology procedure and RFCA in Medical Center of Tsinghua University from April 1994 to December 2014, including 98 male and 25 female, and their average age was (22.9±9.6) months(2-35 months) and body weight was (13.64±2.80) kg(4.66-19.40 kg). The mechanism, RFCA methods, the success rate, recurrence rate and complication rate of the different types of tachycardia were investigated. Results Among these children, interventional electrophysiological study confirmed 94 cases (76.4%, 94/123 cases) with atrioventricular reentrant tachycardia (AVRT), 7 cases(5.7%, 7/123 cases) with atrioventricular nodal reentrant tachycardia (AVNRT), 3 cases (2.4%, 3/123 cases) with focal atrial tachycardia (FAT), 8 cases (6.5%, 8/123 cases) with atrial flutter (AF), 5 cases (4.1%, 5/123 cases) with idiopathic left ventricular tachycardia (ILVT), 6 cases (4.8%, 6/123 cases) arrhythmia was not induced.RFCA was performed in 109 cases (88.6%, 109/123 cases). The success rate of RFCA was 94.5%(103/109 cases) and the recurrence rate was 6.8% (7/103 cases). In 88 cases of AVRT, the success rate was 96.6%(85/88 cases), and the recurrence rate was 8.2%(7/85 cases). In 5 cases of AVNRT, the success rate was 100.0%(5/5 cases). In 3 cases of FAT, the success rate was 33.3%(1/3 cases). In 8 cases of AF, the success rate was 87.5%(7/8 cases). In 5 cases of ILVT, the success rate was 100.0%(5/5 cases), and there was no recurrence.The complication of RFCA was puncture vascular occlusion in 2 cases (1.6%, 2/123 cases), without other serious complications and death cases.In this group of children, the fluoroscopy exposure time was (11.2±5.8) min(5.7-18.2 min) and dose area product(DAP) exposure was (954.5±117.4) mGy×cm2(707-2 201 mGy×cm2). Compared with the elder children (379 cases over 3 years old) of the exposure fluoroscopy time(10.8±6.4) min(3.9-20.5 min) and DAP exposure (927.5±193.4) mGy×cm2(439-3 201 mGy×cm2), there was no statistically significant difference(t=0.616, 1.463, all P>0.05). Conclusions AVRT was the most common type of arrhythmia in infants and a higher incidence of multiple accessory pathways was found in infants.Application of radiofrequency ablation to children with tachycardia arrhythmias can be relatively safe and effective to the infants with drug-resistant tachycardia. Key words: Tachycardia arrhythmia; Radiofrequency catheter ablation; Infant

Successful left-sided accessory pathway ablation without reference catheter in patient with atresia of coronary sinus and thin persistent left superior vena cava

We report a case of atrioventricular reentrant tachycardia (AVRT) with ostial atresia of the coronary sinus (CS). Without the anatomic angiography, radiofrequency (RF) energy was applied at the mitral valve annulus and the bypass tract was eliminated. After the therapy procedure, by CS angiography, we knew the persistent left superior vena cava (PLSVC), and the coronary sinus was connected with vena cava superior, very thin in a diameter. The therapy procedure was successful. The patient has remained completely symptom free.

CLINICAL EFFICACY AND SAFETY EVALUATION OF RADIOFREQUENCY ABLATION TREATMENT OF 36 CHILDREN WITH SUPRAVENTRICULAR TACHYCARDIA

ObjectivesTo investigate the clinical efficacy and safety of radiofrequency ablation treatment of children with supraventricular tachycardia (PSVT).MethodsConventional cardiac electrophysiology examination was performed in 36 children with PSVT to identify PSVT...

The Efficacy and Safety of Catheter Ablation for Supraventricular Tachycardia in Geriatric Patients

Background: The number of geriatric patients is increasing in Japan. Catheter Ablation (CA) is considered the useful treatment of choice for patient with supraventricular tachycardia (SVT). Therefore, it is tend to increase Catheter Ablation (CA) for geriatric patients of SVT. Objective: The aim of this study is to asses the efficacy and safety of CA for SVT except for Atrial Fibrillation (AF) in geriatric patients. Methods and Results: We studied thirty-one consecutive patients aged 75 and older (men 21 cases, median age 78±3, oldest age 88 years old) who underwent CA for SVT between January 2006 and March 2011 in our institution. 31 cases include 15 cases of typical atrial flutter (AFL), 1 case of atypical AFL, 9 cases of atrioventricular nodal re-entrant tachycardia, 5 cases of atrioventricular re-entrant tachycardia, and 1 case of ectopic atrial tachycardia. Initial CA success rate was 100% for all ablation types. And there were no major complications under the operation and after the operation. During observation periods (2.1±1.2 years), there were no recurrence cases except for the atypical AFL (recurrence rate 3.2%). Conclusion: CA of SVT has efficacy and safty and low rates of recurrence. CA is an excellent choice therapy option for geriatric patients with SVT except for atrial fibrillation.

Successful Elimination of Concealed Accessory Pathway‐Mediated Tachycardia by Ablation of AV Nodal Slow Pathway

We report a case of atrioventricular reentrant tachycardia (AVRT) using a concealed para-Hisian accessory pathway for retrograde conduction, which also required anterograde conduction over the AV nodal slow pathway to maintain the tachycardia. The shortest VA interval during AVRT (70 ms) was noted at a site with His bundle electrogram amplitude of 0.25 mV. The AVRT was cured by radiofrequency ablation of the AV nodal slow pathway without affecting accessory pathway conduction. The patient has not reported any sustained palpitations at 2 years after ablation while receiving no medications. The case presented in this report illustrates a para-Hisian AVRT that was successfully eliminated by an unconventional approach of ablation of the atrial inputs to the AV nodal slow pathway.

The mechanisms of exercise provocation of supraventricular tachycardia

Treadmill exercise tests, electrophysiologic studies, and isoproterenol infusions were performed in 14 patients with exercise provocable supraventricular tachycardia to delineate the mechanisms of exercise provocation of paroxysmal supraventricular tachycardia. Treadmill exercise tests reproducibly provoked supraventricular tachycardia in all patients. Supraventricular tachycardia similar to that provoked by exercise occurred spontaneously during isoproterenol infusions in 9 of 11 patients tested. The specific supraventricular tachycardia diagnoses of all patients were atrial reentrant tachycardia (two patients), automatic atrial tachycardia (three), atrial flutter-fibrillation (one), atypical junctional tachycardia (two), and orthodromic atrioventricular (AV) reentrant tachycardia (six) as defined by electrophysiologic studies. Various mechanisms of exercise or isoproterenol induction of supraventricular tachycardia were identified. A critical heart rate and/or appropriate sympathetic state was found to provoke all instances of reentrant or automatic atrial tachycardia and atypical junctional tachycardia. A properly timed atrial premature beat provoked five of six cases of AV reentrant tachycardia and the only case of atrial flutter-fibrillation. The remaining case of AV reentrant tachycardia was induced by a ventricular premature beat. In conclusion, the mechanisms of exercise provocation of reentrant or automatic supraventricular tachycardia are multiple and include a critical sinus rate, increased sympathetic tone, and properly timed atrial or ventricular premature beats.