9. Atrioventricular Junctional Re-entrant Tachycardias

  1. David H. Bennett MD FRCP

Published Online: 1 NOV 2012

DOI: 10.1002/9781118432389.ch9

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

How to Cite

Bennett, D. H. (2012) Atrioventricular Junctional Re-entrant Tachycardias, in Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition, John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118432389.ch9

Author Information

  1. Senior Consultant Cardiologist, University Hospital of South Manchester, Manchester, UK

Publication History

  1. Published Online: 1 NOV 2012
  2. Published Print: 14 JAN 2013

ISBN Information

Print ISBN: 9780470674932

Online ISBN: 9781118432389

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Keywords:

  • Atrioventricular junctional re-entrant tachycardias;
  • Atrioventricular nodal re-entrant tachycardia (AVNRT);
  • Atrioventricular re-entrant tachycardia (AVRT);
  • ECG characteristics;
  • Treatment

Summary

Atrioventricular junctional re-entrant tachycardias are caused by an additional electrical connection between atria and ventricles, allowing an impulse to repeatedly and rapidly travel around the circuit consisting of the normal atrioventricular (AV) junction and the additional connection.

Atrioventricular re-entrant tachycardia (AVRT) is caused by an accessory pathway: a strand of myocardium, congenital in origin, which straddles the groove between atria and ventricles.

In atrioventricular nodal re-entrant tachycardia (AVNRT), the AV node and its adjacent atrial tissues are functionally dissociated into two pathways: fast and slow. Typically, during AVNRT, AV conduction is via the slow pathway and ventriculoatrial conduction is via the fast pathway.

Both AVRT and AVNRT lead to a regular and usually narrow QRS tachycardia. The tachycardias can be terminated by vagal stimulation or by intravenous adenosine. The best approach to preventing recurrence is radiofrequency catheter ablation.