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Distinctive characteristics of His bundle potentials in patients with atrioventricular nodal reentrant tachycardia
, 1, 1, 1, 1, 13, 13, 1, 1, 14
Affiliations- Arrhythmia and Electrophysiology Division, Department of Cardiology, University Heart Center, Zurich, Switzerland
- Department of Cardiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Cardiology, GZO Regional Health Center Wetzikon, Switzerland
- Center for Integrative Human Physiology, University of Zurich, Switzerland
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Abstract
Background: His bundle (HB) potentials vary in amplitude and duration in patients with and without
slow pathways. The aim of this study was to determine the characteristics of HB potentials and to
elucidate whether they can provide clues for identification of slow pathway (SP).
Methods: The present research prospectively studied the electrophysiological findings of 162 patients
with symptomatic atrioventricular nodal reentrant tachycardia (AVNRT) due to slow-fast or fast-slow
type and atrioventricular reentrant tachycardia (AVRT). Maximal HB potential (HBmax, HB with the
highest amplitude) among HB cloud was recorded in both groups. For AVNRT patients, the following
were measured: (1) AH interval at the “jump” during programmed atrial stimulation (A2H2, taken
as a reflection of SP conduction time); (2) Distance from HBmax to the successful SP ablation site
(HBmax-ABL) and from HBmax to the ostium of coronary sinus (HBmax-CSO).
Results: HBmax was 0.29 ± 0.10 mV in AVNRT patients, whereas it was 0.17 ± 0.05 mV in AVRT
group (p < 0.0001). Likewise, the HBmax duration was 22 ± 5 ms in AVNRT group and 16 ± 3 ms
in AVRT group (p < 0.0001). The area under the receiver operating characteristic curve of HBmax
amplitude in AVNRT patients was 0.86 and the optimal HBmax cut-off to predict AVNRT was
≥ 0.22 mV with a sensitivity of 0.78 and specificity of 0.84. HBmax-CSO was positively correlated with
HBmax-ABL, and HBmax-ABL was positively correlated with A2H2.
Conclusions: HBmax amplitudes were higher and durations longer in patients with AVNRT, as
compared to those with AVRT. Moreover, the distance between HBmax and successful ablation site
was positively correlated with the SP conduction time and with the distance from HBmax to the CSO.
Abstract
Background: His bundle (HB) potentials vary in amplitude and duration in patients with and without
slow pathways. The aim of this study was to determine the characteristics of HB potentials and to
elucidate whether they can provide clues for identification of slow pathway (SP).
Methods: The present research prospectively studied the electrophysiological findings of 162 patients
with symptomatic atrioventricular nodal reentrant tachycardia (AVNRT) due to slow-fast or fast-slow
type and atrioventricular reentrant tachycardia (AVRT). Maximal HB potential (HBmax, HB with the
highest amplitude) among HB cloud was recorded in both groups. For AVNRT patients, the following
were measured: (1) AH interval at the “jump” during programmed atrial stimulation (A2H2, taken
as a reflection of SP conduction time); (2) Distance from HBmax to the successful SP ablation site
(HBmax-ABL) and from HBmax to the ostium of coronary sinus (HBmax-CSO).
Results: HBmax was 0.29 ± 0.10 mV in AVNRT patients, whereas it was 0.17 ± 0.05 mV in AVRT
group (p < 0.0001). Likewise, the HBmax duration was 22 ± 5 ms in AVNRT group and 16 ± 3 ms
in AVRT group (p < 0.0001). The area under the receiver operating characteristic curve of HBmax
amplitude in AVNRT patients was 0.86 and the optimal HBmax cut-off to predict AVNRT was
≥ 0.22 mV with a sensitivity of 0.78 and specificity of 0.84. HBmax-CSO was positively correlated with
HBmax-ABL, and HBmax-ABL was positively correlated with A2H2.
Conclusions: HBmax amplitudes were higher and durations longer in patients with AVNRT, as
compared to those with AVRT. Moreover, the distance between HBmax and successful ablation site
was positively correlated with the SP conduction time and with the distance from HBmax to the CSO.
Keywords
tachycardia, atrioventricular nodal reentry, slow pathway, His bundle, catheter ablation
About this articleTitle
Distinctive characteristics of His bundle potentials in patients with atrioventricular nodal reentrant tachycardia
Journal
Issue
Article type
Original Article
Pages
431-439
Published online
2021-09-23
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2362
Article views/downloads
524
DOI
Pubmed
Bibliographic record
Cardiol J 2023;30(3):431-439.
Keywords
tachycardia
atrioventricular nodal reentry
slow pathway
His bundle
catheter ablation
Authors
Fu Guan
Ardan M. Saguner
Daniel Hofer
Thomas Wolber
Alexander Breitenstein
Nazmi Krasniqi
Urs Eriksson
Jan Steffel
Corinna Brunckhorst
Firat Duru
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