Katritsis Demosthenes G, Josephson Mark E
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Arrhythm Electrophysiol Rev. 2016 Aug;5(2):130-5. doi: 10.15420/AER.2016.18.2.
Atrioventricular nodal reentrant tachycardia (AVNRT) should be classified as typical or atypical. The term 'fast-slow AVNRT' is rather misleading. Retrograde atrial activation during tachycardia should not be relied upon as a diagnostic criterion. Both typical and atypical atrioventricular nodal reentrant tachycardia are compatible with varying retrograde atrial activation patterns. Attempts at establishing the presence of a 'lower common pathway' are probably of no practical significance. When the diagnosis of AVNRT is established, ablation should be only directed towards the anatomic position of the slow pathway. If right septal attempts are unsuccessful, the left septal side should be tried. Ablation targeting earliest atrial activation sites during typical atrioventricular nodal reentrant tachycardia or the fast pathway in general for any kind of typical or atypical atrioventricular nodal reentrant tachycardia, are not justified. In this review we discuss current concepts about the tachycardia circuit, electrophysiologic diagnosis, and ablation of this arrhythmia.
房室结折返性心动过速（AVNRT）应分为典型或非典型。“快慢型AVNRT”这一术语颇具误导性。不应将心动过速期间的逆行心房激动作为诊断标准。典型和非典型房室结折返性心动过速均与不同的逆行心房激动模式相符。试图确定“下共同通路”的存在可能并无实际意义。当AVNRT的诊断确立后，消融应仅针对慢径的解剖位置。如果右间隔部位的尝试不成功，应尝试左间隔侧。针对典型房室结折返性心动过速期间最早心房激动部位或针对任何类型典型或非典型房室结折返性心动过速的快径进行消融是不合理的。在本综述中，我们讨论了关于这种心律失常的心动过速环路、电生理诊断和消融的当前概念。
