Reappraised Target at Lower Koch’s Triangle for Atrioventricular Nodal Reentry
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概要
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<B>Background:</B> Catheter-ablation (CA) for atrioventricular nodal reentrant tachycardia (AVNRT) has aimed at site demonstrating slow pathway potential (SP). However, CA could often eliminate at site without obvious SP near atrioventricular annulus (AVA). This study reappraised successful CA site for AVNRT. <B>Method:</B> This study comprised 38 pts. CA started at levels P1-2 near AVA showing fragmented local potential (LP) with atrio-ventricular potential ratio (AVR)<0.3 (Group A N=28) and at levels P1-2 demonstrating SP with AVR>0.3 (Group B N=10). CA target could be changed to that initially made in another group if failed. LP frequency (LF) at CA sites was assessed. <B>Results:</B> CA at initial target site eliminated AVNRT in 18 (64%) and 5 (50%) pts for Groups A and B, respectively (NS). The remaining pts needed to change CA site and to upper levels M1-2 in 4 and 1 pts for Groups A and B, respectively. AVR at initial sites with success was significantly lower in Group A than B (0.08±0.05 vs. 0.33±0.18, P<0.05). LF at initial sites with success was significantly higher than that without success in Group A (101±30 vs. 65±17 Hz P<0.01), but it did not differ in Group B (110±28 vs. 9±10 Hz NS). LF at any CA sites with success in both groups was significantly higher than that without success (111±32 vs. 71±22 Hz P<0.05). <B>Conclusion:</B> This study may suggest that critical slow pathway reflected in high-frequency small LP with low AVR exists adjacent to AVA and can be target for CA of AVNRT.
著者
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Ueno Akira
Division of Cardiology, Department of Internal Medicine, Nippon Medical School
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Kobayashi Yoshinori
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Morita Norishige
Division Of Cardiology Department Of Internal Medicine Nippon Medical School
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Iida Takayuki
Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital
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