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The electrophysiology of atrioventricular nodal reentry tachycardia following the Mustard or Senning procedure and its radiofrequency ablation

  • Anne E. Greene (a1), Jonathan R. Skinner (a2), Anne M. Dubin (a1), Kathryn K. Collins (a1) and George F. Van Hare (a1)...

Abstract

We describe the electrophysiological studies undertaken in four patients with atrioventricular nodal reentry tachycardia in the setting of concordant atrioventricular and discordant ventriculo-arterial connections (transposition). Radiofrequency ablation was attempted in three, all with success. Clear evidence of dual antegrade pathways through the atrioventricular node was present in only one of the four, but other characteristics of discrete fast and slow pathways into the atrioventricular node were present in all. Atrioventricular nodal reentry tachycardia was inducible in all. In the three patients in whom ablation was attempted, the application of radiofrequency energy to the low medial regions of the systemic venous atrium (morphologically left) consistently caused junctional accelerated rhythm, but these lesions were not successful in eliminating the tachycardia. Successful radiofrequency ablation required a retrograde approach to the region of the slow pathway in the pulmonary venous atrium (morphologically right).

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Corresponding author

Correspondence to: Anne Greene MD, Director, Pediatric Arrhythmias and Electrophysiology, Division of Pediatric Cardiology, NYU Hospitals Center, 550 First Avenue SKI 9U, New York, NY 10016, USA. Tel: +1 212 263 5940; Fax: +1 212 263 5808; E-mail: anne.greene@med.nyu.edu

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References

Van Hare GF, Chiesa NA, Campbell RM, Kanter RJ, Cecchin F. Atrioventricular nodal reentrant tachycardia in children: effect of slow pathway ablation on fast pathway function. J Cardiovasc Electrophysiol 2002; 13: 203209.
Isaacson R, Titus JL, Merideth J, Feldt RH, McGoon DC. Apparent interruption of atrial conduction pathways after surgical repair of transposition of great arteries. Am J Cardiol 1972; 30: 533535.
Flinn CJ, Wolff GS, Dick M, 2nd, et al. Cardiac rhythm after the Mustard operation for complete transposition of the great arteries. N Engl J Med 1984; 310: 16351638.
Vetter VL, Tanner CS. Electrophysiologic consequences of the arterial switch repair of d-transposition of the great arteries. J Am Coll Cardiol 1988; 12: 229237.
el-Said G, Rosenberg HS, Mullins CE, Hallman GL, Cooley DA, McNamara DG. Dysrhythmias after Mustard's operation for transposition of the treat arteries. Am J Cardiol 1972; 30: 526532.
Gillette PC, Kugler JD, Garson Jr A, Gutgesell HP, Duff DF, McNamara DG. Mechanisms of cardiac arrhythmias after the Mustard operation for transposition of the great arteries. Am J Cardiol 1980; 45: 12251230.
Duster MC, Bink-Boelkens MT, Wampler D, Gillette PC, McNamara DG, Cooley DA. Long-term follow-up of dysrhythmias following the Mustard procedure. Am Heart J 1985; 109: 13231326.
Gelatt M, Hamilton RM, McCrindle BW, et al. Arrhythmia and mortality after the Mustard procedure: a 30-year single-center experience. J Am Coll Cardiol 1997; 29: 194201.
Gillette PC, el-Said GM, Sivarajan N, Mullins CE, Williams RL, McNamara DG. Electrophysiological abnormalities after Mustard's operation for transposition of the great arteries. Br Heart J 1974; 36: 186191.
Sunderland CO, Henken DP, Nichols GM, et al. Postoperative hemodynamic and electrophysiologic evaluation of the interatrial baffle procedure. Am J Cardiol 1975; 35: 660666.
Wittig JH, Stark J. Intraoperative mapping of atrial activation before, during, and after the Mustard operation. J Thorac Cardiovasc Surg 1977; 73: 113.
Leier CV, Meacham JA, Schaal SF. Prolonged atrial conduction. A major predisposing factor for the development of atrial flutter. Circulation 1978; 57: 213216.
Southall DP, Keeton BR, Leanage R, et al. Cardiac rhythm and conduction before and after Mustard's operation for complete transposition of the great arteries. Br Heart J 1980; 43: 2130.
Stark SI, Rosenfeld LE, Kleinman CS, Batsford WP. Atrial dissociation: an electrophysiologic finding in a patient with transposition of the great arteries. J Am Coll Cardiol 1986; 8: 236238.
Ullal RR, Anderson RH, Lincoln C. Mustard's operation modified to avoid dysrhythmias and pulmonary and systemic venous obstruction. J Thorac Cardiovasc Surg 1979; 78: 431439.
Kanter RJ, Papagiannis J, Carboni MP, Ungerleider RM, Sanders WE, Wharton JM. Radiofrequency catheter ablation of supraventricular tachycardia substrates after mustard and senning operations for d-transposition of the great arteries. J Am Coll Cardiol 2000; 35: 428441.
Ebert PA. Atlas of Congenital Cardiac Surgery. Churchill Livingstone, Inc., New York, 1989.
Ebert PA, Gay Jr WA, Engle MA. Correction of transposition of the great arteries: Relationship of the coronary sinus and postoperative arrhythmias. Ann Surg 1974; 180: 433438.
Josephson ME, Wellens HJ. Electrophysiologic evaluation of supraventricular tachycardia. Cardiol Clin 1997; 15: 567586.
Shah D, Haissaguerre M, Gaita F. Slow pathway ablation for atrioventricular nodal reentry. J Cardiovasc Electrophysiol 2002; 13: 10541055.
Jackman WM, Beckman KJ, McClelland JH, et al. Treatment of supraventricular tachycardia due to atrioventricular nodal reentry, by radiofrequency catheter ablation of slow-pathway conduction. N Engl J Med 1992; 327: 313318.
Deshpande S, Akhtar M, Panotopoulos P. Catheter ablation for atrioventricular nodal reentrant tachycardia. Cardiol Clin 1997; 15: 623645.
Zuberbuhler JR, Bauersfeld SR. Unusual arrhythmias after corrective surgery for transposition of the great vessels. Am Heart J 1967; 73: 752755.
Beerman LB, Neches WH, Fricker FJ, et al. Arrhythmias in transposition of the great arteries after the Mustard operation. Am J Cardiol 1983; 51: 15301534.
Cronin CS, Nitta T, Mitsuno M, et al. Characterization and surgical ablation of acute atrial flutter following the Mustard procedure. A canine model. Circulation 1993; 88: II461II471.
Chan DP, Van Hare GF, Mackall JA, Carlson MM, Waldo AL. Importance of atrial flutter isthmus in postoperative intra-atrial reentrant tachycardia. Circulation 2000; 102: 12831289.
Moulton K, Miller B, Scott J, Woods Jr WT. Radiofrequency catheter ablation for AV nodal reentry: a technique for rapid transection of the slow AV nodal pathway. Pacing Clin Electrophysiol 1993; 16: 760768.

Keywords

The electrophysiology of atrioventricular nodal reentry tachycardia following the Mustard or Senning procedure and its radiofrequency ablation

  • Anne E. Greene (a1), Jonathan R. Skinner (a2), Anne M. Dubin (a1), Kathryn K. Collins (a1) and George F. Van Hare (a1)...

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