The atrioventricular nodal reentrant tachycardia circuit: a proposal

Heart Rhythm. 2007 Oct;4(10):1354-60. doi: 10.1016/j.hrthm.2007.05.026. Epub 2007 Jun 8.

Abstract

Several models of the atrioventricular nodal reentrant tachycardia circuit have been proposed. Recently, there has been experimental and clinical electrophysiology evidence that the right and left inferior extensions of the human atriventricular node and the atrionodal inputs they facilitate may provide the anatomic substrate of the slow pathway. Inferior nodal extensions appear to constitute a necessary limb of the tachycardia circuit in all forms of atrioventricular nodal reentrant tachycardia and represent the ablation target for all forms of this arrhythmia. Anatomic variations of multiple atrionodal inputs via atrial transitional cells may create the conditions for tachycardia inducibility and differing patterns of retrograde atrial activation. In the present article, we summarize the available evidence and propose a comprehensive model of the tachycardia circuit for all forms of atrioventricular nodal reentrant tachycardia based on the concept of atrionodal inputs.

Publication types

  • Review

MeSH terms

  • Atrioventricular Node / pathology
  • Atrioventricular Node / physiopathology*
  • Cardiac Pacing, Artificial
  • Catheter Ablation
  • Coronary Sinus / pathology
  • Coronary Sinus / physiopathology
  • Coronary Sinus / surgery
  • Electrocardiography*
  • Heart Atria / pathology
  • Heart Atria / physiopathology
  • Heart Atria / surgery
  • Heart Septum / pathology
  • Heart Septum / physiopathology
  • Heart Septum / surgery
  • Heart Ventricles / pathology
  • Heart Ventricles / physiopathology
  • Heart Ventricles / surgery
  • Humans
  • Signal Processing, Computer-Assisted*
  • Tachycardia, Atrioventricular Nodal Reentry / pathology
  • Tachycardia, Atrioventricular Nodal Reentry / physiopathology*
  • Tachycardia, Atrioventricular Nodal Reentry / surgery
  • Treatment Outcome