22. Atrioventricular Nodal Reentrant Tachycardia: Current Understanding and Controversies

  1. Mohammad Shenasa MD4,
  2. Gerhard Hindricks MD5,
  3. Martin Borggrefe MD6,
  4. Günter Breithardt MD7 and
  5. Mark E. Josephson MD8
  1. Mohammad-Reza Jazayeri1,
  2. Edward T. Keelan2 and
  3. Mohammad-Ali Jazayeri3

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch22

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Jazayeri, M.-R., Keelan, E. T. and Jazayeri, M.-A. (2013) Atrioventricular Nodal Reentrant Tachycardia: Current Understanding and Controversies, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch22

Editor Information

  1. 4

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 5

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 6

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 7

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 8

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. 1

    Bellin Health Hospital Center, Green Bay, WI, USA

  2. 2

    Mater Private Healthcare, Dublin, Ireland

  3. 3

    Medical College of Wisconsin, Milwaukee, WI, USA

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585

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Keywords:

  • AV nodal reentrant tachycardia;
  • supraventricular tachycardia;
  • AV node reentry;
  • pseudo-block;
  • fast pathway;
  • slow pathway;
  • common pathway;
  • catheter ablation;
  • radio-frequency;
  • cryoablation

Summary

Atrioventricular nodal reentrant tachycardia (AVNRT), the most common regular supraventricular tachycardia, has fascinated cardiac electrophysiologists for several decades. The reentrant circuit consists of at least two pathways, which are essentially atrio-nodal connections with different electrophysiological (EP) properties, known as fast and slow pathways in reference to their conduction times. Three forms of AVNRT, slow/fast, fast/slow and slow/slow, have generally been recognized based on the conduction time and the anatomical location of each reentrant pathway. Another intriguing form, which features a variable AH/HA ratio and may readily be misdiagnosed as atrial tachycardia, is described in this chapter. In addition, several other interesting phenomena observed during EP studies are elucidated, and a few controversial issues regarding the anatomical boundaries of the AVNRT circuit are addressed. Finally, transcatheter mapping and ablation techniques, currently used in EP laboratories, are highlighted and practical approaches are delineated.