Key result
Superior atypical AVNRT exhibits ~82 ms shorter TCL versus inferior type, requiring right midseptum ablation.
Why the study?
Atypical AVNRTs usually exhibit earliest retrograde atrial activation at the right inferoseptum or proximal coronary sinus, but characteristics of those with earliest activation at the right superoseptum were not well characterized.
Does slow pathway ablation at the right midseptum effectively eliminate superior type atypical AVNRT?
Comparison
Superior type with ERAA at right superoseptum vs inferior type with ERAA at right inferoseptum or proximal coronary sinus
Design
Observational study
Authors
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Clinicians should map Rt-SS in atypical AVNRT; extends classification but leaves open optimal ablation targets.
Observational (n=63)
Does slow pathway ablation at the right midseptum effectively eliminate superior type atypical AVNRT?
Absolute Event Rate: 322% vs 404%
p-value: p=< 0.02
Atypical AVNRT with earliest retrograde atrial activation at the right superoseptum (superior type) has distinct electrophysiological characteristics and requires ablation at the right midseptum rather than the conventional right inferoseptum for successful elimination.
Otomo et al. (2008) conducted an observational in Atypical atrioventricular nodal reentrant tachycardias (AVNRT) (n=63). Superior type of atypical AVNRT vs. Inferior type of atypical AVNRT was evaluated on Tachycardia cycle length (TCL) (p=< 0.02). The superior type of atypical AVNRT exhibited a significantly shorter tachycardia cycle length compared to the inferior type (322 vs 404 ms; P<0.02) and required ablation at the right midseptum.
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