Distinguishing and diagnosis of right atrioventricular accessory pathway originating from the coronary sinus ostium from atrioventricular nodal reentrant tachycardia
Li Ying*， Zhao Yingjie,Guo Fangming,Sun Yu,Wang Jing,Chu Jianmin
*Department of Cardiology of Jilin Central Hospital
Abstract：ObjectiveTo investigate the distinguishing and diagnosis of the complex accessory pathway by the entrainment and RS2.MethodsOne patient with intermittent WolffParkinsonWhite syndrome was undergone electrophysiologic study.The entrainment and RS2 were performed on right ventricular apex,and the stimulationAtrium minus VentricularAtrium (SAVA) and Post Pacing Interval minus Tachycardia Cycle Length (PPITCL) were measured.The conventional ablation was performed.ResultsThe TCL was 372ms,the PPI was 395ms,the tachycardia was induced by classfication:fractional stimulation was demonstrated with ventricular S1S1:350ms and programmed stimulation was demonstrated with atrium S1S2:500/310ms.Atrioventricular nodal reentrant tachycardia was induced by atrium S1S1:280ms.The programmed S2 stimulation was performed with the tachycardia of accessory pathway.The PPI was 385.1ms and the TCL was 360.1ms，PPITCL<20ms.The tachycardia was confirmed for atrioventricular nodal reentrant tachycardia and interval atrioventricular accessory pathway.The forward pass was the slow conduction and the retrograde was right atrioventricular accessory pathway.ConclusionThe SVVA interval and PPITCL are useful in distinguishing and diagnosis with atrioventricular nodal reentrant tachycardia form atrioventricular accessory pathway by entrainment.
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