he diagnosis of dual AV nodal pathways compliTcating concealed or manifest preexcitation, is usually made at the time of electrophysiologic study in pa tien ts with recurrent paroxysmal supraventriculax tachycardia. In these patients, electrophysiologic studies demonstrate discontinuous antegrade AV nodal conduction curves (dual AV nodal pathways, fast and slow), as well as a unior bidirectiona...

catheter ablation is an accepted, highly effective modality of treatment for cardiac arrhythmias in children. the success rate depends on the operator’s experience, especially in cases involving complex anatomies. we hereby report our recent experience of successful ablation of accessory pathways in three children with complex congenital heart diseases. the first case was a 7-year-old girl with...

background: complete atrioventricular block (av block) is a serious complication of slow pathway ablation therapy in the treatment of atrioventricular nodal re-entrant tachycardia (avnrt).   the present study was aimed at determining whether the electroanatomical pace mapping of koch’s triangle could significantly improve the safety, efficiency, and efficacy of selective slow pathway ablation i...

OBJECTIVES This study assessed the use of adenosine triphosphate (ATP) in the noninvasive diagnosis of concealed accessory pathway (AP) and dual atrioventricular (AV) node physiology in patients with inducible AV reentrant tachycardia (AVRT). BACKGROUND Administration of ATP during sinus rhythm identifies dual AV node physiology in 76% of patients with inducible sustained slow/fast AV nodal r...

In case of the first possibility (AVRT), an accessory pathway is responsible for the retrograde limb of the tachycardia circuit (there is no evidence for anterograde conduction over the accessory pathway on the ECG in sinus rhythm, as show in Fig. 1b of the question). Therefore a ‘concealed’ accessory pathwaymust be present. Anterograde conduction occurs over a dual AV nodal pathway (Fig. 2, up...

A case of incessant supraventricular tachycardia continuing despite AV block is reported. Atrial tachycardia and AV nodal reentrant tachycardia were excluded, as was orthodromic tachycardia using a concealed accessory AV pathway. The earliest retrograde atrial activation was at the posterolateral tricuspid annulus, and the tachycardia was eliminated by ablation at this site. The findings in thi...

avnrt, (atrioventricular nodal reentry tachycardia), atrial tachycardia and atrial flutter are 3 kinds of supraventricular tachycardia, which their mechanism are explained based on reentry. a 60-years-old man is presented with all of the above-mentioned arrhythmias, responsive to intravenous injection of adenosine. radiofrequency ablation of the slow pathway territories cured all of them. there...