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The electrophysiology of atrioventricular nodal reentry tachycardia following the Mustard or Senning procedure and its radiofrequency ablation

Published online by Cambridge University Press:  18 November 2005

Anne E. Greene ,
Jonathan R. Skinner ,
Anne M. Dubin ,
Kathryn K. Collins  and
George F. Van Hare
Anne E. Greene
Affiliation:
Department of Pediatrics, Division of Cardiology, Stanford University, Stanford, California, and the University of California San Francisco, California, United States of America
Jonathan R. Skinner
Affiliation:
Department of Paediatrics, Green Lane Hospital, Auckland, New Zealand
Anne M. Dubin
Affiliation:
Department of Pediatrics, Division of Cardiology, Stanford University, Stanford, California, and the University of California San Francisco, California, United States of America
Kathryn K. Collins
Affiliation:
Department of Pediatrics, Division of Cardiology, Stanford University, Stanford, California, and the University of California San Francisco, California, United States of America
George F. Van Hare
Affiliation:
Department of Pediatrics, Division of Cardiology, Stanford University, Stanford, California, and the University of California San Francisco, California, United States of America
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Abstract

We describe the electrophysiological studies undertaken in four patients with atrioventricular nodal reentry tachycardia in the setting of concordant atrioventricular and discordant ventriculo-arterial connections (transposition). Radiofrequency ablation was attempted in three, all with success. Clear evidence of dual antegrade pathways through the atrioventricular node was present in only one of the four, but other characteristics of discrete fast and slow pathways into the atrioventricular node were present in all. Atrioventricular nodal reentry tachycardia was inducible in all. In the three patients in whom ablation was attempted, the application of radiofrequency energy to the low medial regions of the systemic venous atrium (morphologically left) consistently caused junctional accelerated rhythm, but these lesions were not successful in eliminating the tachycardia. Successful radiofrequency ablation required a retrograde approach to the region of the slow pathway in the pulmonary venous atrium (morphologically right).

Keywords

Transpositionatrial redirection operationsarrhythmiasinterventional catheterisation
Type
Original Article
Information
Cardiology in the Young , Volume 15 , Issue 6 , December 2005 , pp. 611 - 616
Copyright
© 2005 Cambridge University Press

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