Yu Chih-Chieh, Lai Ling-Ping, Lin Jiunn-Lee
Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2005 Dec;104(12):951-4.
Whether atrium tissue is involved in the reentrant circuit of atrioventricular nodal reentrant tachycardia (AVNRT) has been debated for decades. Animal models, clinical electrophysiological studies, surgery and catheter ablation have all documented that the perinodal tissue forms part of the tachycardia circuit. However, the occasional clinical finding of AVNRT with ventriculoatrial block suggests the presence of a proximal common pathway. We describe a 43-year-old woman who developed recurrent AVNRT with new onset of complete ventriculoatrial block after an attempted radiofrequency ablation at the posterior septal area. This case demonstrates the anatomical existence of a proximal common pathway and the topological location of such a pathway for typical AVNRT. This case also demonstrates the isolated nature of the AVNRT circuit and the delicate nature of the responsible reentrant substrate.
几十年来，心房组织是否参与房室结折返性心动过速（AVNRT）的折返环路一直存在争议。动物模型、临床电生理研究、手术及导管消融均证实，结周组织是心动过速环路的一部分。然而，AVNRT伴室房阻滞的偶然临床发现提示存在近端共同通路。我们描述了一名43岁女性，她在尝试对后间隔区域进行射频消融后出现复发性AVNRT，并新发完全性室房阻滞。该病例证实了典型AVNRT近端共同通路的解剖学存在及其拓扑位置。该病例还证实了AVNRT环路的独立性以及相关折返基质的精细特性。
