Advanced Concepts of Atrioventricular Nodal Electrophysiology: Observations on the Mechanisms of Atrioventricular Nodal Reciprocating Tachycardias

Giuseppe Bagliani; Fabio M Leonelli; Roberto De Ponti; Luigi Padeletti

doi:10.1016/j.ccep.2018.02.004

Advanced Concepts of Atrioventricular Nodal Electrophysiology: Observations on the Mechanisms of Atrioventricular Nodal Reciprocating Tachycardias

Card Electrophysiol Clin. 2018 Jun;10(2):277-297. doi: 10.1016/j.ccep.2018.02.004.

Authors

Giuseppe Bagliani¹, Fabio M Leonelli², Roberto De Ponti³, Luigi Padeletti⁴

Affiliations

¹ Cardiology Department, Arrhythmology Unit, Foligno General Hospital, Via Massimo Arcamone, Foligno 06034, Italy; Cardiovascular Diseases Department, University of Perugia, Piazza Menghini 1, 06129 Perugia, Italy. Electronic address: giuseppe.bagliani@tim.it.
² Cardiology Department, James A. Haley Veterans' Hospital, University South Florida, 13000 Bruce B Down Boulevard, Tampa, FL 33612, USA.
³ Cardiology Department, University of Insubria, Via Ravasi, 2, 21100 Varese, Italy.
⁴ Heart and Vessels Department, University of Florence, Largo Brambilla, 3, Florence 50134, Italy; IRCCS Multimedica, Cardiology Department, Via Milanese, 300, 20099 Sesto San Giovanni, Italy.

PMID: 29784484
DOI: 10.1016/j.ccep.2018.02.004

Abstract

Atrioventricular node reentrant tachycardia (AVNRT) is a supraventricular arrhythmia easily diagnosed by 12-lead electrocardiogram. What is far more challenging, is the understanding of the reentrant circuit in its typical and atypical presentations. The function of the atrioventricular node is still incomplete and this knowledge gap is reflected in the reconstruction of the pathways used by AVNRT in its multiform presentations. This article illustrates the heterogeneous electrocardiographic manifestations of AVNRT. We reconstruct the reentrant circuits involved using more recent understanding of the anatomic and electrophysiologic characteristics of the atrioventricular node.

Keywords: Arrhythmias; Atrioventricular node; Electrophysiology; Reentrant tachycardia; Supraventricular tachycardias.

Publication types

Review

MeSH terms

Atrioventricular Node / physiopathology*
Cardiac Pacing, Artificial / methods*
Diagnosis, Differential
Electrocardiography / methods*
Humans
Tachycardia, Atrioventricular Nodal Reentry* / diagnosis
Tachycardia, Atrioventricular Nodal Reentry* / physiopathology
Tachycardia, Atrioventricular Nodal Reentry* / therapy