Cycle Length-Dependent Retrograde Conduction over a Concealed Atrioventricular Accessory Pathway

概要

論文の詳細を見る
A 78-year-old man had recurrent episodes of tachycardia and was referred for radiofrequency ablation. An ECG recorded showed a narrow QRS tachycardia with a cycle length of 270 ms, during which pseudo r was observed in V1 lead, suggesting that the tachycardia is due to atrioventricular nodal reentrant tachycardia. At electrophysiological study, ventricular extrastimulus testing was performed with a basic drive cycle length of 600 ms. At coupling intervals of 460 ms to 340 ms, the earliest retrograde atrial activation was recorded from His bundle region, with decremental conduction property. At coupling intervals of 330 ms to 280 ms, ventricullar-atrial (VA) conduction time abruptly shortened (310 ms to 140 ms), and the earliest retrograde atrial activation transferred to the orifice of the coronary sinus with no decremental conduction property. At coupling intervals at 270 ms or less, VA conduction time prolonged (144 ms to 383 ms). The earliest retrograde atrial activation returned to His bundle resion with decremental conduction property. After radiofrequency ablation targeting antegrade slow pathway, both antegrade AV slow pathway conduction and short VA conduction disappeared. We consider that the existence of cycle length-dependent retrograde conduction over a concealed accessory atrioventricular pathway could explain our phenomenon. As cycle length-dependent retrograde conduction over a concealed accessory pathway is rare, the possible mechanisms of which should be carefully discussed.
日本不整脈学会の論文

Cycle Length-Dependent Retrograde Conduction over a Concealed Atrioventricular Accessory Pathway

スポンサーリンク

概要

著者

関連論文

スポンサーリンク