Ablation of accessory atrioventricular pathways pathway conduction. Medical search. Frequent questions

Alternatively, the electrical conduction through an accessory pathways can be abolished using catheter ablation, potentially offering a permanent cure. (wikipedia.org)
Radiofrequency catheter ablation techniques are safe and effective as well, especially for patients with poor tolerance to drugs (see figure figure 3b radiofrequency ablation in WPW, as well as in the treatment of atrial flutter and fibrillation by identifying tract carrying the excitation impulse). (rjmatthewsmd.com)
Of the 108 patients studied 77 (71%) were treated only pharmacologically, in 4 (3.7) children RF catheter ablation was done, in 8 (7.4%) patients septal myectomy was performed. (czytelniamedyczna.pl)
Radiofrequency ablation is usually accomplished using transvenous catheter supplied low-voltage, high-frequency (300 to 750 MHz) electrical radiofrequency (RF) energy. (msdmanuals.com)
Catheter ablation is a first-line treatment for many cardiac arrhythmias and is generally performed under X-ray fluoroscopy guidance. (rmmj.org.il)
Radiofrequency (RF) catheter ablation has advanced over the last 25 years from an experimental procedure to the first-line treatment for a number of cardiac arrhythmias including atrioventricular re - entrant tachycardia, accessory pathway-associated tachycardias, and typical atrial flutter. (rmmj.org.il)
The clinical indications for anatomy-based catheter ablation have since expanded to more complex arrhythmias such as atrial fibrillation and scar-based ventricular tachycardia. (rmmj.org.il)
4 , 5 The basis of these strategies is to target specific anatomic regions and often to create extended ablation "lines" by aligning multiple point lesions or by dragging the catheter along the endocardial surface while applying ablative energy. (rmmj.org.il)
Catheter ablation is almost always preferred for long-term prevention of recurrent arrhythmias involving an accessory pathway. (ccasociety.org)
Catheter ablation is an effective treatment option for cardiac arrhythmia. (mdpi.com)
NEVER GIVE Dig/BB/CCB/Adenosine) Needs Cardio consult and Catheter ablation. (abcmedicalnotes.com)
Patients presenting with pre-excited AF once managed should be referred for definitive treatment which is radiofrequency catheter ablation of the accessory pathway, not only to eliminate symptoms of palpitations but also to eliminate the risk of sudden death. (abcmedicalnotes.com)
Catheter ablation is a first-line therapy for treatment of AVNRT. (medtronic.com)

These pathways can lead to abnormal heart rhythms or arrhythmias associated with symptoms of palpitations. (wikipedia.org)
The combination of an accessory pathway that causes pre-excitation with arrhythmias is known as Wolff-Parkinson-White syndrome. (wikipedia.org)
If conduction to the ventricles occurs solely through the pathway (maximal pre-excitation), as occurs during arrhythmias like antidromic atrioventricular re-entrant tachycardia, the ECG appearance is of QRS complexes with a left bundle branch block morphology which can be mistaken for ventricular tachycardia. (wikipedia.org)
Pre-procedure 3-D magnetic resonance imaging (MRI) has improved understanding of the anatomic basis of complex arrhythmias and is being used for planning and guidance of ablation procedures. (rmmj.org.il)
In the future, intra-procedure real-time MRI, together with the ability to image complex 3-D arrhythmogenic anatomy and target additional ablation to regions of incomplete lesion formation, may allow for more successful treatment of even complex arrhythmias without exposure to ionizing radiation. (rmmj.org.il)
While the feasibility of X-ray fluoroscopy guidance has been demonstrated for these complex arrhythmias, precise targeting of ablation lesions is limited by fluoroscopy's inherently poor ability to visualize cardiovascular soft tissue anatomy. (rmmj.org.il)
For decades, there have been remarkable advancements in mapping and ablation techniques and technology, helping clinicians further understand the mechanism of arrhythmias, in order to facilitate procedures, and to improve the safety of ablation and patients' clinical outcomes. (mdpi.com)
The aim and scope of this Special Issue mainly focus on, but are not limited to, the following: current mapping and ablation techniques for arrhythmias, procedural endpoints and outcomes, procedural complications, and prevention strategies. (mdpi.com)

not from the ventricles to the atria (retrograde conduction). (wikipedia.org)
When there is a disturbance in the normal conduction through the fast pathway, the slow pathway may be activated to conduct the excitation wave to the bundle of His, as well as retrograde back to the fast one, and then back again down the slow pathway continuously to produce the PSVT (see Figure 1). (rjmatthewsmd.com)
A stable narrow complex tachycardia typically results from orthodromic AVRT with antegrade conduction via the AVN followed by retrograde conduction along the AP. (ccasociety.org)
A stable wide-complex tachycardia results from antidromic AVRT with antegrade conduction over the accessory pathway and onto the ventricles followed by retrograde conduction back to the atria via the AVN. (ccasociety.org)
Dofetilide increased the atrial and ventricular effective refractory periods, as well as the antegrade and retrograde effective refractory period of the accessory pathway. (bmj.com)
Normal conduction passes anterogradely through the AV node with no retrograde conduction. (abcmedicalnotes.com)

The most common sites for accessory pathways are connections between muscle tissue in the atria and the ventricles (atrio-ventricular pathways), bypassing the atrioventricular node. (wikipedia.org)

IN WPW an accessory pathway that only conducts retrogradely (i.e. no resting ECG delta wave) is called a CONCEALED pathway and those with antegrade conduction where the delta wave is obvious is called a MANIFEST pathway. (abcmedicalnotes.com)

[ 1 ] Currently, Wolff-Parkinson-White (WPW) syndrome is defined as a congenital condition involving abnormal conductive cardiac tissue between the atria and the ventricles that provides a pathway for a reentrant tachycardia circuit, in association with supraventricular tachycardia (SVT). (medscape.com)
Reentrant Supraventricular Tachycardias (SVT) Including Wolff-Parkinson-White Syndrome Reentrant supraventricular tachycardias (SVT) involve reentrant pathways with a component above the bifurcation of the His bundle. (msdmanuals.com)
The typical supraventricular tachycardia associated with WPW syndrome is atrioventricular reentrant or reciprocating tachycardia (AVRT). (ccasociety.org)
This can lead to an Atrioventricular reentrant tachycardia which may pass anterogradely or retrogradely through the AV node and accessory pathway. (abcmedicalnotes.com)
DUBLIN , Feb. 18, 2022 / PRNewswire / -- Medtronic plc (NYSE:MDT), a global leader in healthcare technology, today announced that the Freezor™ and Freezor™ Xtra Cardiac Cryoablation Focal Catheters are the first and only ablation catheters approved by the U.S. Food and Drug Administration (FDA) to treat the growing prevalence of pediatric Atrioventricular Nodal Reentrant Tachycardia (AVNRT). (medtronic.com)
An unusual case of non-reentrant atrioventricular nodal tachycardia. (jefferson.edu)

For example, the administration of neostigmine which causes slowing of the heart rate due to decreased atrioventricular nodal conduction can divert conduction to the accessory pathway. (ccasociety.org)
340 bpm) during atrial flutter or when physiologic processes facilitate AV nodal conduction, such that a rapid ventricular response can still result in sudden death. (medscape.com)

Unlike most atrio-ventricular accessory pathways which conduct electrical impulses at a relatively fixed speed, conduction through a Mahaim pathway varies according to how rapidly it is stimulated. (wikipedia.org)
Pulsed electrical field ablation uses a train of high voltage, short duration electrical impulses that kill cardiac myocytes in a non-thermal method. (msdmanuals.com)
The AP conducts electrical impulses faster resulting in a shorter PR interval in the surface ECG and has a shorter refractory period than the atrioventricular node (AVN). (ccasociety.org)
In normal cardiac conduction, the atria and ventricles are electrically separate from one another, and electrical impulses must pass through the atrioventricular (AV) node and His-Purkinje system. (picmonic.com)
A specialized cluster of cells called the atrioventricular node conducts electrical impulses from the heart's upper chambers (the atria) to the lower chambers (the ventricles). (nih.gov)
The accessory pathway may also transmit electrical impulses abnormally from the ventricles back to the atria. (nih.gov)

Rarer sites include connections between atrial muscle and the conducting tissue within the ventricles (atrio-fascicular pathways), between the atrioventricular node and the muscle tissue of the ventricle (nodo-ventricular pathways), and between the conducting tissue of the ventricle and the ventricular muscle (fasciculo-ventricular pathways). (wikipedia.org)
F. The most common form of paroxysmal supraventricular tachycardia (PSVT) is AV nodal reentry due to dual pathways of excitation in the region of the AV node (see Figure 1). (rjmatthewsmd.com)
Because of its selective class III antiarrhythmic effect, dofetilide has no effect on atrioventricular conduction or sinus node function. (bmj.com)
Patients with WPW and other "pre-excitation" syndromes have alternative, or "accessory" pathways which allow electricity to flow directly from the atria to the ventricles, bypassing the AV node and leading to "premature" activation of the ventricles. (picmonic.com)
Avoid AV node blocking agents like adenosine and beta blockers as these agents further promote conduction through the accessory pathway and increase the risk of ventricular fibrillation. (picmonic.com)
This allows quick conduction from the atria to the ventricles bypassing the AV node. (abcmedicalnotes.com)
A type of atrial arrhythmia characterized by atrial rates of between 240 and 400 beats per minute and some degree of atrioventricular node conduction block. (nih.gov)
Impulses move through the atrioventricular node during each heartbeat, stimulating the ventricles to contract slightly later than the atria. (nih.gov)
n\nPeople with Wolff-Parkinson-White syndrome are born with an extra connection in the heart, called an accessory pathway, that allows electrical signals to bypass the atrioventricular node and move from the atria to the ventricles faster than usual. (nih.gov)

Pharmacological treatment of supraventricular tachycardia remains a common approach despite the increased use of radiofrequency ablation. (bmj.com)

G. There is a slow conduction pathway as well as a fast one. (rjmatthewsmd.com)
A flutter circuit typically surrounds an anatomical or functional barrier and includes a zone of slow conduction (or conduction over an extended circuit) and an area of unidirectional block, as required for reentry of all types. (medscape.com)
Such circuits may encircle anatomical barriers such as atriotomy scars or surgical anastomoses, and they may use areas of slow conduction along baffle limbs and other sites of injury in addition to the tricuspid valve-coronary sinus isthmus. (medscape.com)

CONCLUSIONS Dofetilide shows promise as an agent for the prevention of atrioventricular re-entrant tachycardia in patients without structural heart disease. (bmj.com)

In the case of antidromic AVRT, the best option is procainamide, which is classified as a sodium-channel blocker that slows conduction in both the AVN and the AP. (ccasociety.org)
The arrhytmia can be antidromic (going down the AVNode and then back via accessory pathway) or antidromic going the opposite direction. (abcmedicalnotes.com)

Due to an abnormal circuit within the heart's conduction system, AVNRT causes a very rapid heart rhythm, and if left untreated, can affect the heart's ability to pump normally, leading to palpitations, lightheadedness, and syncope. (medtronic.com)

In 1943, the existence of an accessory connection between atria and ventricles was confirmed, which is about 50 years after Kent's description of myocardial fibers that were believed to conduct from atria to ventricle. (rjmatthewsmd.com)
In WPW, an accessory conduction pathway exists which directly connects the atria and ventricles. (picmonic.com)

Wide complex tachycardia may also result from orthodromic AVRT with aberrant QRS conduction resulting in a wide QRS complex. (ccasociety.org)

the ventricular rate may be less when AV conduction is incomplete. (rjmatthewsmd.com)

METHODS: We selected patients that underwent VT ablation with the integration of EAM and CMR processed using ADAS software and imported to the CARTO system using VTK file format. (bvsalud.org)
CONCLUSION: CMR aided is ablation is feasible and effective in patients with scar related VT. (bvsalud.org)
Fifty one patients with electrically inducible atrioventricular re-entrant tachycardia were allocated to one of five doses of dofetilide (1.5, 3, 6, 9, and 15 μg/kg), two thirds of the dofetilide dose being given over a 15 minute loading period and the remainder over a 45 minute maintenance period. (bmj.com)
MAIN OUTCOME MEASURE Responders were defined as patients in whom dofetilide prevented reinduction of atrioventricular re-entrant tachycardia at the end of the infusion. (bmj.com)
Our goal in this study was to assess the efficacy of intravenous dofetilide, in five different dosing regimens, for treating patients with inducible atrioventricular re-entrant tachycardia, by determining its ability to prevent reinduction of the tachycardia. (bmj.com)
Ablation therapy may be superior to antiarrhythmics in selected patients, including those with paroxysmal atrial fibrillation who are symptomatic but without structural heart disease, patients who are intolerant of antiarrhythmics, and patients with inadequate pharmacologic rhythm control. (aafp.org)
Atrial ventricular nodal ablation is recommended for patients refractory to medical therapy, usually older patients needing a pacemaker. (aafp.org)
Ullah W, Ruge M, Hajduczok AG, Kochar K, Frisch DR, Pavri BB, Alvarez R, Rajapreyar IN, Brailovsky Y. Adverse outcomes of atrial fibrillation ablation in heart failure patients with and without cardiac amyloidosis: a Nationwide Readmissions Database analysis (2015-2019). (jefferson.edu)

Wolff-Parkinson-White (WPW) syndrome is a form of pre-excitation with characteristic abnormalities on the ECG and an increased predisposition to tachyarrhythmias involving an accessory pathway. (ccasociety.org)
However, especially in the presence of congenital or acquired structural or conduction abnormalities, a subset of dysrhythmias (ie, sustained VT and VF) may pose an immediate threat to life by causing profound hemodynamic instability. (medscape.com)

However, due to their slow decremental conduction, during sinus rhythm the 12-lead ECG will often show little pre-excitation. (wikipedia.org)
The typical findings of AP function in sinus rhythm are preexcitation, in which depolarization of the ventricles occurs in part or fully through the accessory pathway that is separate from the AVN and earlier than expected after atrial depolarization. (ccasociety.org)

Cryoablation can reduce the risk of permanent AV block, a complication of AVNRT procedures performed with radiofrequency (RF) ablations that results in the partial or complete interruption of the heart's electrical signals, which dangerously disrupts heart rhythm. (medtronic.com)
Wolff-Parkinson-White syndrome is a condition characterized by abnormal electrical pathways in the heart that cause a disruption of the heart's normal rhythm (arrhythmia). (nih.gov)

Accessory pathways may not require any treatment, but those causing symptoms may be treated with medication including calcium channel antagonists, beta blockers or flecainide. (wikipedia.org)

Conduction system pacing in pediatric and congenital heart disease. (stanfordchildrens.org)

Those that have WPW syndrome have ventricular pre-excitation caused by an accessory conduction pathway. (picmonic.com)
n\nComplications of Wolff-Parkinson-White syndrome can occur at any age, although some individuals born with an accessory pathway in the heart never experience any health problems associated with the condition. (nih.gov)

WPW - there is an abnormal electrical connection between atrium and ventricle (e.g. bundle of Kent) - this is called an accessory pathway. (abcmedicalnotes.com)

Atrial fibrillation (AF) can be very dangerous in the setting of WPW, as conduction of atrial impulses at rates of up to 500 beats per minute can result in ventricular tachycardia or ventricular fibrillation. (ccasociety.org)

High-intensity exercise can also utilize an additional metabolic pathway, the creatine kinase reaction, to facilitate rapid production of ATP ( 1 ). (musculoskeletalkey.com)

Mahaim pathways are typically seen on the right side of the heart, with their ventricular connection lying within or close to the right bundle branch. (wikipedia.org)

In the fetus, atrial flutter is defined as a rapid regular atrial rate of 300-600 bpm accompanied by variable degrees of atrioventricular (AV) conduction block, resulting in slower ventricular rates. (medscape.com)
During this type of tachycardia, the atrial rate is so rapid that normal AV nodes usually display a physiologic second-degree block, with a resultant 2:1 conduction ratio. (medscape.com)

Definitive treatment of Wolff-Parkinson-White requires procedural ablation of the accessory pathway. (picmonic.com)

Ablation therapy is used to destroy abnormal foci responsible for atrial fibrillation. (aafp.org)

2 By directing ablation to interrupt conduction through this region, high cure rates have been achieved with a low risk of complications. (rmmj.org.il)

More frequent stimulation leads to slower conduction, known as decremental conduction. (wikipedia.org)

CONCLUSIONS: Transatrial access allows epicardial mapping and ablation. (bvsalud.org)

In individuals with accessory AV nodal pathways, a 1:1 conduction ratio may occur through the accessory pathway with resultant ventricular rates of 260-340 bpm, which can cause sudden death. (medscape.com)

The Cardiac Rhythm Management (CRM) Pathway assumes no prior knowledge of the cardiac space, beginning with foundational lessons in anatomy and rhythm analysis and progresses all the way to advanced concepts and virtual clinical rotations. (meddevicecareers.com)

The presence of an accessory pathway influences the choice of correct pharmacologic treatment. (ccasociety.org)

An accessory pathway is an additional electrical connection between two parts of the heart. (wikipedia.org)

Studies in this population have repeatedly demonstrated superior hemodynamics and outcomes compared to conventional pacing with the recruitment of the native conduction system. (stanfordchildrens.org)

Atrioventricular re-entrant tachycardia is currently treated with various pharmacological agents. (bmj.com)

Conduction system pacing versus biventricular pacing: Reduced repolarization heterogeneity in addition to improved depolarization. (jefferson.edu)
Conduction system pacing (CSP) has evolved rapidly to become the pacing method of choice for many adults with structurally normal hearts. (stanfordchildrens.org)

Successful targeting of ablation primarily to the anatomic arrhythmia substrate, as opposed to mapping and targeting ablation based on electrogram characteristics, began with recognition that common atrial flutter passes through a narrow structure known as the cavo-tricuspid isthmus. (rmmj.org.il)

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