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[双房室结非折返性心动过速(DAVNNT):未被认识的鉴别诊断及其深远影响]

[Dual AV nodal nonreentry tachycardia (DAVNNT): unrecognized differential diagnosis with far-reaching consequences].

作者信息

Kirmanoglou Kiriakos, Peiker Christiane, Clasen Lukas, Shin Dong-In, Kelm Malte, Meyer Christian

机构信息

Abteilung für Rhythmologie, Klinik für Kardiologie Pneumologie und Angiologie, Heinrich-Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.

出版信息

Herzschrittmacherther Elektrophysiol. 2014 Jun;25(2):109-15. doi: 10.1007/s00399-014-0310-1. Epub 2014 May 16.

Abstract

BACKGROUND

The dual atrioventricular nodal nonreentry tachycardia (DAVNNT) is a rare form of tachycardia which occurs due to a time delayed double antegrade conduction via the slow and fast atrioventricular nodal pathways. Its epidemiology is not known so far. The aim of this article is to present the clinical findings in a series of patients with DAVNNT.

MATERIALS AND METHODS

We retrospectively analyzed our database of patients who successfully underwent radiofrequency catheter ablation between January 2012 and March 2013 due to diagnosed supraventricular tachycardia.

RESULTS

In 3 out of 231 patients DAVNNT could be successfully treated by slow pathway modulation/ablation. Patients presented with widely varying symptoms including syncope, palpitations which had been mistaken as atrial fibrillation, and inappropriate defibrillator shocks due to suspected ventricular tachycardia.

CONCLUSIONS

The DAVNNT seems to be more common than previously thought. This important differential diagnosis needs to be taken into consideration as slow pathway modulation can be curative while a misdiagnosis, such as atrial fibrillation or ventricular tachycardia might result in over-treatment in patients with this arrhythmia.

摘要

背景

双房室结非折返性心动过速(DAVNNT)是一种罕见的心动过速形式,它是由于经慢、快房室结径路的时间延迟双向前传传导所致。其流行病学至今尚不明确。本文旨在介绍一系列DAVNNT患者的临床发现。

材料与方法

我们回顾性分析了2012年1月至2013年3月期间因诊断为室上性心动过速而成功接受射频导管消融的患者数据库。

结果

231例患者中有3例通过慢径路调制/消融成功治疗DAVNNT。患者表现出广泛多样的症状,包括晕厥、被误诊为房颤的心悸,以及因疑似室性心动过速而不适当的除颤器电击。

结论

DAVNNT似乎比以前认为的更常见。这种重要的鉴别诊断需要考虑,因为慢径路调制可能治愈,而误诊为房颤或室性心动过速等可能导致该心律失常患者过度治疗。

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