Ho Reginald T, Ortman Matthew, Levi Steven A
Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Division of Cardiology, Cooper Medical School of Rowan University, Camden, New Jersey.
Heart Rhythm. 2020 Aug;17(8):1280-1290. doi: 10.1016/j.hrthm.2020.03.026. Epub 2020 Apr 5.
The various arrhythmic manifestations of concealed nodofascicular (NF)/nodoventricular (NV) bypass tracts (BPTs) are poorly understood.
The purpose of the study was to define diagnostic criteria for supraventricular tachycardias (SVTs) associated with concealed nodal pathways (NPs).
We reviewed 11 patients with concealed NPs who underwent electrophysiology study and ablation for symptomatic SVT.
Of 11 patients 7 (64% women; mean age 54 ± 16 years), NF/NV BPTs were active bystanders during atrioventricular nodal reentrant tachycardia (atypical [n = 4]; typical [n =2]) or participants during orthodromic NF/NV reentrant tachycardia (n = 5). The majority (10 of 11 [91%]) had nodal origin in the slow pathway (SP) and 7 of 11 (64%) presented as long RP SVT. Ablation of the SP targeting the right (n = 10) or left (n = 1) inferior extension eliminated concealed NP-associated SVTs in all patients.
Concealed NF/NV BPTs are active bystanders equally as common as participants during SVT. They typically insert into the SP and often present as long RP SVT. SP ablation eliminates concealed NF/NV BPT-associated SVTs regardless of the mechanism.
隐匿性结-束支（NF）/结-心室（NV）旁路（BPTs）的各种心律失常表现尚未得到充分了解。
本研究旨在确定与隐匿性结径路（NPs）相关的室上性心动过速（SVTs）的诊断标准。
我们回顾了11例因症状性SVT接受电生理检查和消融治疗的隐匿性NPs患者。
11例患者中，7例（64%为女性；平均年龄54±16岁），NF/NV BPTs在房室结折返性心动过速（非典型[n = 4]；典型[n = 2]）时为活跃旁观者，或在顺向性NF/NV折返性心动过速（n = 5）时参与其中。大多数（11例中的10例[91%]）结径路起源于慢径路（SP），11例中的7例（64%）表现为长RP SVT。针对右（n = 10）或左（n = 1）下延的SP消融消除了所有患者中与隐匿性NP相关的SVTs。
隐匿性NF/NV BPTs在SVT期间作为活跃旁观者与参与者同样常见。它们通常插入SP，且常表现为长RP SVT。无论机制如何，SP消融均可消除与隐匿性NF/NV BPT相关的SVTs。
