Catheter ablation via the left atrium for atrioventricular nodal reentrant tachycardia: A narrative review

Figures

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  Figure 1. Atrioventricular nodal conduction curves. Stimulation sequences associated with echo beats are indicated with red dots and those associated with initiation of sustained supraventricular tachycardia are indicated with green dots. A: At case start, programmed atrial stimulation with single extrastimuli using a drive cycle length (CL) of 600 ms demonstrated 2 jumps. B: During infusion of isoproterenol 1 μg/min, only the jump using the second slow pathway persisted with programmed atrial stimulation using a drive CL of 500 ms.

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  Figure 2. A: Induction of supraventricular tachycardia on isoproterenol 1 μg/min using a drive cycle length (CL) of 500 ms and a single atrial extrastimulus with a coupling interval of 260 ms from the proximal coronary sinus electrode. B: Ventricular overdrive pacing maneuver at a CL of 310 ms.

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  Figure 3. A: Electroanatomic map in the right anterior oblique projection. B: Electroanatomic map in the left anterior oblique projection. Cardiac chambers are color-coded to indicate the right atrium (gray), the proximal coronary sinus (lavender), and a portion of the left atrium (teal). Dots are color-coded to indicate His bundle electrograms (yellow), right atrial or coronary sinus ablation lesions not associated with junctional beats (red), right atrial ablation lesions associated with junctional beats (green), a left atrial ablation lesion not associated with junctional beats (purple), and a left atrial ablation lesion associated with junctional beat (blue). C: Electrograms at the successful site. D: Left anterior oblique 14° fluoroscopy image with the ablation catheter at the successful site.

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  Figure 4. Postablation atrioventricular nodal conduction curves. A: Programmed atrial stimulation with a drive cycle length (CL) of 400 ms and single extrastimuli from the proximal coronary sinus. B: At case end, 7 minutes after cessation of isoproterenol, programmed atrial stimulation with a drive CL of 600 ms and single extrastimuli from the proximal coronary sinus.

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  Figure 5. Relevant atrioventricular junction segments using the anatomically correct nomenclature.21 AV = atrioventricular; CS = coronary sinus; I = inferior; IPS = inferoposteroseptal; PI = posteroinferior; S = septal; SPS = superoparaseptal.

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  Figure 6. Literature flow diagram. MeSH = Medical Subject Headings.