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Titolo:
THE EFFECT OF VARIABLE RETROGRADE PENETRATION ON DUAL AV NODAL PATHWAYS - OBSERVATIONS BEFORE AND AFTER SLOW PATHWAY ABLATION LDD
Autore:
LI HG; YEE R; THAKUR RK; KLEIN GJ;
Indirizzi:
UNIV NEBRASKA,MED CTR,DEPT INTERNAL MED,CARDIOL SECT,600 S 42ND ST OMAHA NE 68198 UNIV WESTERN ONTARIO,DEPT MED LONDON ON N6A 3K7 CANADA
Titolo Testata:
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
fascicolo: 9, volume: 20, anno: 1997,
parte:, 1
pagine: 2146 - 2153
SICI:
0147-8389(1997)20:9<2146:TEOVRP>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
ATRIOVENTRICULAR NODE; ATRIAL-FIBRILLATION; CONDUCTION;
Keywords:
AV NODAL PATH WAYS; EFFECTIVE REFRACTORY PERIOD; PATHWAY ABLATION;
Tipo documento:
Article
Natura:
Periodico
Citazioni:
13
Recensione:
Indirizzi per estratti:
Citazione:
H.G. Li et al., "THE EFFECT OF VARIABLE RETROGRADE PENETRATION ON DUAL AV NODAL PATHWAYS - OBSERVATIONS BEFORE AND AFTER SLOW PATHWAY ABLATION LDD", PACE, 20(9), 1997, pp. 2146-2153

Abstract

Retrograde VA conduction is usually or er the fast pathway and rarelyover the slow pathway in patients with dual AV nodal pathways. It is unknown whether this apparent unidirectional conduction of the slow pathway is due to the lack of its retrograde conducting ability or the result of concealment. The effect of variable retrograde AV nodal penetration on antegrade AV nodal conduction was determined in patients with typical AV nodal reentrant tachycardia before and after the slow pathway ablation. Variable retrograde penetration was produced by delivering a ventricular extrastimulus simultaneously with (VE-0), 50 ms after (VE-50), or 100 ms after (VE-100) the last basic atrial stimulus, while atrial extrastimuli were used to determine changes of anterograde AV nodal effective refractory period (ERP) and A-H interval. The AV nodal functions measured without the ventricular extrastimuli sen ed as the baseline. Although the mean slow pathway ERP rr as not significantly different among the different stimulation protocols, a significant shortening of the slow pathway conduction time (A-H from 348 +/- 60 to324 +/- 119 ms, P < 0.05) was observed with upper level retrograde penetration of the Air node (VE-0). This facilitating effect became a prolonging effect when the retrograde penetration level moved to the lower level (VE-100, A-H from 324 +/- 119 to 366 +/- 122 ms P < 0.05). The fast path rr av ERP shortened with an upper level penetration (VE-0)but tended to prolong with a lower level retrograde penetration (VE-100) both before and after the slow pathway ablation (preablation, from348 +/- 143 of the baseline to 302 +/- 114 to 360 +/- 143 ms, P < 0.05; postablation, from 314 +/- 101 of the baseline to 274 +/- 118 to 361 +/- 143 ms, P < 0.05). The mean A(2)-H-2 interval of the slow pathway was significantly shorter than the baseline (350 +/- 44 ms) with VE-0 (249 +/- 48 ms, P < 0.05) and VE-50 stimulation (285 +/- 82 ms, P < 0.05) but not with VE-100 stimulation (330 +/- 83 ms, P = NS). Before slow pathway ablation, the A(2)-H-2 interval of the fast pathway at equal coupling intervals was shorter than the baseline (165 +/- 53 ms) with VE-0 (144 +/- 47 ms, P < 0.01) and VE-50 stimulation (152 +/- 43 ms, P < 0.05) but tended to be longer with VE-100 stimulation (175 +/- 47 ms, P = NS). After slow pathway ablation, the mean A(2)-H-2 interval at the same coupling interval rr as shorter than the baseline (173 +/- 39 ms) with VE-0 (139 +/- 35 ms, P < 0.05), VE-50 (153 +/- 32 ms, P= 0.05) but tended to be longer with VE-100 stimulation (178 +/- 49 ms, P = NS). We conclude that: (I) concealed retrograde conduction can be demonstrated in both the slow and rhs fast ii Ir nodal pathways; and (2) concealed retrograde conduction may either shorten or prolong anterograde refractoriness and conduction time, depending on the level of retrograde penetration.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 07:33:02