Diagnosis and Therapy of AV Nodal Reentrant Tachycardia
摘要
Atrioventricular nodal reentrant tachycardia (AVNRT) is the most common regular supraventricular tachycardia in clinical practice. Pathophysiologically, this cardiac arrhythmia is based on a dual conduction property in the AV node. The paroxysmal symptoms typically include an on/off phenomenon, regular palpitations, and pulse-synchronous pounding in the neck area. The reentrant tachycardia can be interrupted by Valsalva maneuvers or adenosine administration. Electrocardiographically, it presents as a narrow complex tachycardia with an unrecognizable or retrograde P wave. In the electrophysiology (EP) lab, typical AVNRT must be differentiated from atypical forms of AVNRT as well as from concealed WPW syndrome or focal atrial tachycardias. In symptomatic AVNRT, ablation/modulation of the slow pathway is the therapy of choice with a low complication rate and excellent prospects of success. This chapter describes the characteristics of AVNRT as well as techniques for differential diagnosis and ablation treatment in the EP lab.