European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE)

In the paper

“Among the calcium channel blockers the experience is greatest with verapamil which overall appear to be relatively safe.405”

What the sources say

• Not checked yetcites [405] Weber-Schoendorfer, 2008, The safety of calcium channel blockers during pregnancy: a prospective, multicenter, observational study, Reprod Toxicol source

In the paper

“The exact incidence of PSVT during pregnancy is not well established, but seems to be relatively low.395”

What the sources say

• Not checked yetcites [395] Li, 2008, Frequency and outcome of arrhythmias complicating admission during pregnancy: experience from a high-volume and ethnically-diverse obstetric service, Clin Cardiol source

In the paper

“As shown in Table 20, RF ablation procedures resulted in substantial improvement of QoL and cost reduction at long term, with a highly favourable ('dominant') cost-utility profile.”

What the sources say

• Not checked yetcites [247] Cheng, 2000, Cost-effectiveness of radiofrequency ablation for supraventricular tachycardia, Ann Intern Med source

In the paper

“Direct current cardioversion can be performed at all stages of pregnancy and is considered safe.402”

What the sources say

• Not checked yetcites [402] Tromp, 2011, Electrical cardioversion during pregnancy: safe or not?, Neth Heart J source

In the paper

“Catheter ablation has been performed in selected cases and has been reported effective with minimal maternal and foetal complications.408”

What the sources say

• Not checked yetcites [408] Driver, 2015, Catheter ablation of arrhythmia during pregnancy, J Cardiovasc Electrophysiol source

In the paper

“Consequently, patients with SVT may restrict their normal daily and leisure activities (social events, sports, and sexual relationships), 16,419 and may be unable to initiate or continue certain 'high-risk' occupations (flying, competitive athletics etc.) 1,2,419 or drive, 422,423 all of which can adversely affect a patient's QoL.”

What the sources say

• Not checked yetcites [1] Blomstrom-Lundqvist, 2003, Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular A. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias), Circulation source
• Not checked yetcites [2] Page, 2016, 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society, J Am Coll Cardiol source
• Not checked yetcites [419] Lane, 2015, Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE), Europace source
• Not checked yetcites [422] Walfridsson, 2005, The impact of supraventricular tachycardias on driving ability in patients referred for radiofrequency catheter ablation, Pacing Clin Electrophysiol source
• Not checked yetcites [423] Dhala, 1995, Impairment of driving abilities in patients with supraventricular tachycardias, Am J Cardiol source

In the paper

“Almost all of the studies examining QoL, measured with validated questionnaires, have been conducted in patients undergoing catheter ablation for SVT, 245,246,254 - 256,258,424,425 although often without a comparison group.”

What the sources say

• Not checked yetcites [245] Farkowski, 2014, Gender-related differences in outcomes and resource utilization in patients undergoing radiofrequency ablation of supraventricular tachycardia: results from Patients' Perspective on Radiofrequency Catheter Ablation of AVRT and AVNRT Study, Europace source
• Not checked yetcites [246] Wood, 2010, Patient perception of symptoms and quality of life following ablation in patients with supraventricular tachycardia, Heart Lung source
• Not checked yetcites [254] Goldberg, 2002, Long-term outcomes on quality-of-life and health care costs in patients with supraventricular tachycardia (radiofrequency catheter ablation versus medical therapy), Am J Cardiol source
• Not checked yetcites [255] Larson, 1999, Quality of life before and after radiofrequency catheter ablation in patients with drug refractory atrioventricular nodal reentrant tachycardia, Am J Cardiol source
• Not checked yetcites [256] Bubien, 1996, Effect of radiofrequency catheter ablation on health-related quality of life and activities of daily living in patients with recurrent arrhythmias, Circulation source
• Not checked yetcites [258] Bathina, 1998, Radiofrequency catheter ablation versus medical therapy for initial treatment of supraventricular tachycardia and its impact on quality of life and healthcare costs, Am J Cardiol source
• Not checked yetcites [424] Meissner, 2009, Sustained high quality of life in a 5-year long term follow-up after successful ablation for supra-ventricular tachycardia. results from a large retrospective patient cohort, Int J Med Sci source
• Not checked yetcites [425] Yildirim, 2012, The effect of radiofrequency ablation treatment on quality of life and anxiety in patients with supraventricular tachycardia, Eur Rev Med Pharmacol Sci

In the paper

“Avoidance of overnight stay, with an average cost of $450, resulted in important savings for the institution ($365 000), and this was coupled with a reassuring patient safety profile.418”

What the sources say

• Not checked yetcites [418] Theodoreson, 2015, Same-day cardiac catheter ablation is safe and cost-effective: experience from a UK tertiary center, Heart Rhythm source

In the paper

“Limitations to participation in social activities and driving are most frequently reported and appear to have the greatest negative impact on QoL. 419”

What the sources say

• Not checked yetcites [419] Lane, 2015, Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLEACE), Europace source

In the paper

“Robotic techniques and sophisticated anatomical navigation systems have been developed, and it is now possible to perform ablation without exposing the operator to radiation and ergonomically unfavourable positions.426”

What the sources say

• Not checked yetcites [426] Nakagawa, 2016, Catheter ablation of complex tachyarrhythmias using remote magnetic catheter navigation system, J Cardiovasc Electrophysiol

In the paper

“Mathematical modelling and numerical analyses have also been employed in the investigation of the circuit of AVNRT.221,232”

What the sources say

• Not checked yetcites [221] Katritsis, 2015, Atypical atrioventricular nodal reentrant tachycardia: prevalence, electrophysiologic characteristics, and tachycardia circuit, Europace source
• Not checked yetcites [232] Katritsis, 2015, Coexistent types of atrioventricular nodal re-entrant tachycardia: implications for the tachycardia circuit, Circ Arrhythm Electrophysiol source

In the paper

“New data on the genetics of SVT continually appear since the identification of a missense mutation in the gene PRKAG2, that encodes the regulatory g-subunit of AMP-activated protein kinase, as a cause of familial Wolff -Parkinson -White syndrome.429,430”

What the sources say

• Not checked yetcites [429] Gollob, 2001, Identification of a gene responsible for familial Wolff-Parkinson-White syndrome, N Engl J Med source
• Not checked yetcites [430] Wolf, 2008, Reversibility of PRKAG2 glycogen-storage cardiomyopathy and electrophysiological manifestations, Circulation source

In the paper

“The proportion of AVRT decreased with age, whereas the proportion of AVNRT and AT increased.”

What the sources say

• Not checked yetcites [9] Porter, 2004, Influence of age and gender on the mechanism of supraventricular tachycardia, Heart Rhythm source

In the paper

“These data translate to 200 000 new cases of AFL in the USA annually, the arrhythmia being more common in men, the elderly and individuals with pre-existing heart failure or chronic obstructive lung disease.”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source

In the paper

“Based on these old data, it was estimated that there are 89 000 new cases per year, and 570 000 patients with paroxysmal SVT in the USA.”

What the sources say

• Not checked yetcites [4] Orejarena, 1998, Paroxysmal supraventricular tachycardia in the general population, J Am Coll Cardiol source

In the paper

“Only 3 subjects (1.7%) were labelled as having 'lone AFL'.”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source

In the paper

“Polyuria may be a symptom supportive of a sustained supraventricular arrhythmia, related to the release of atrial natriuretic peptide in response to increased atrial pressures.This is most pronounced in AVNRT.15”

What the sources say

• Not checked yetcites [15] Abe, 1997, Neurohumoral and hemodynamic mechanisms of diuresis during atrioventricular nodal reentrant tachycardia, Pacing Clin Electrophysiol source

In the paper

“Porter et al. described 1754 patients undergoing catheter ablation, where AVNRT was the most common (56%) aetiology, followed by AVRT 27%, and atrial tachycardia (AT) 17%. 9”

What the sources say

• Not checked yetcites [9] Porter, 2004, Influence of age and gender on the mechanism of supraventricular tachycardia, Heart Rhythm source

In the paper

“If the irregularity does not exceed 15% of the CL, a reentry is possible, while above this threshold, a focal arrhythmia is much more likely.18”

What the sources say

• Not checked yetcites [18] Jais, 2009, A deductive mapping strategy for atrial tachycardia following atrial fibrillation ablation: importance of localized reentry, J Cardiovasc Electrophysiol source

In the paper

“For AFL, one report from MESA of 181 new cases of AFL estimated an overall incidence of 88/100 000 person-years.11”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source

In the paper

“Recently, in the first Latin American registry on catheter ablation including 15 099 procedures from 120 centres in 13 participating countries, AVRT was the group of arrhythmias most frequently ablated (31%), followed by AVNRT (29%), typical AFL (14%), and AF (11%).10”

What the sources say

• Not checked yetcites [10] Keegan, 2015, The first Latin American Catheter Ablation Registry, Europace source

In the paper

“In MESA, AFL had an incidence of 0.09% and 58% of the patients also had AF.”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source

In the paper

“An cut-off interval of 90 ms has been shown to be useful for surface ECG measurements and can be used if P waves are visible, 20”

What the sources say

• Not checked yetcites [20] Letsas, 2010, Electrocardiographic differentiation of common type atrioventricular nodal reentrant tachycardia from atrioventricular reciprocating tachycardia via a concealed accessory pathway, Acta Cardiol source

In the paper

“Incidence rates ranged from 5/100 000 in those ,50 years old to 587/100 000 in subjects older than 80 years.”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source

In the paper

“A very short RP interval (,70 ms) rules out AVRT and indicates typical AVNRT or, less commonly AT, as the most likely diagnosis.The 70 ms cut-off interval is based on VA intervals that have been examined in electrophysiology studies.”

In the paper

“Data from specialized centres reporting on paroxysmal SVT patients referred for electrophysiology procedures, indicate that patients tend to be younger, have similar age distribution, and lower prevalence of cardiovascular comorbidities.5 -7”

What the sources say

• Not checked yetcites [5] Clair, 1993, Spontaneous occurrence of symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia in untreated patients, Circulation source
• Not checked yetcites [6] Lu, 2014, Epidemiological profile of Wolff-Parkinson-White syndrome in a general population younger than 50 years of age in an era of radiofrequency catheter ablation, Int J Cardiol source
• Not checked yetcites [7] Rodriguez, 1992, Age at onset and gender of patients with different types of supraventricular tachycardias, Am J Cardiol source

In the paper

“although symptoms may be minimal and, on certain occasions, prolonged asymptomatic episodes may lead to a tachycardiomyopathy. 14”

What the sources say

• Not checked yetcites [14] Ellis, 2013, What about Tachycardia-induced cardiomyopathy?, Arrhythm Electrophysiol Rev source

In the paper

“Atrial flutter was 2.5-fold more common in men”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source

In the paper

“An ECG taken during tachycardia is of key importance for the proper diagnosis of SVT, although it may fail to lead to a specific diagnosis.17”

What the sources say

• Not checked yetcites [17] Katritsis, 2015, Differential diagnosis of regular, narrow-QRS tachycardias, Heart Rhythm source

In the paper

“Most patients with AVRT were male (55%), in contrast to patients with AVNRT and AT who were predominantly female (70% and 62%, respectively).”

What the sources say

• Not checked yetcites [9] Porter, 2004, Influence of age and gender on the mechanism of supraventricular tachycardia, Heart Rhythm source

In the paper

“In a 3.5% sample of medical records in the Marshfield (Wisconsin) Epidemiologic Study Area (MESA) the prevalence of paroxysmal SVT was 2.25/1000 persons, and the incidence was 35/100 000 person-years. 4”

What the sources say

• Not checked yetcites [4] Orejarena, 1998, Paroxysmal supraventricular tachycardia in the general population, J Am Coll Cardiol source

In the paper

“Paroxysmal AF is often asymptomatic whilst paroxysmal SVT is usually symptomatic, 13”

What the sources say

• Not checked yetcites [13] Page, 1994, Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia, Circulation source

In the paper

“Wide-QRS tachycardias can be ventricular tachycardias, and supraventricular tachycardias conducting with bundle-branch block aberration, or over an accessory pathway, with a reported proportion of 80%, 15% and 5%, respectively (Figure 4).53”

What the sources say

• Not checked yetcites [53] Alzand, 2011, Diagnostic criteria of broad QRS complex tachycardia: decades of evolution, Europace source

In the paper

“Most VTs, as opposed to SVTs, do not respond to carotid sinus massage, although a narrow-QRS VT originating from the left bundle branch, and terminated with carotid sinus massage has been reported.26”

What the sources say

• Not checked yetcites [26] Alzand, 2009, An ‘almost wide’ QRS tachycardia, Circ Arrhythm Electrophysiol source

In the paper

“The underlying mechanism of inappropriate sinus tachycardia remains poorly understood and is likely to be multifactorial.94”

What the sources say

• Not checked yetcites [94] Olshansky, 2013, Inappropriate sinus tachycardia, J Am Coll Cardiol source

In the paper

“Effectiveness of vagal manoeuvres in terminating SVT has been reported as between 19.4 -54%, 66 -68 with higher success rates in the supine position.69”

What the sources say

• Not checked yetcites [66] Lim, 1998, Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage, Ann Emerg Med source
• Not checked yetcites [67] Smith, 2015, Effectiveness of the Valsalva Manoeuvre for reversion of supraventricular tachycardia, Cochrane Database Syst Rev
• Not checked yetcites [68] Wen, 1998, Electrophysiological mechanisms and determinants of vagal maneuvers for termination of paroxysmal supraventricular tachycardia, Circulation source
• Not checked yetcites [69] Appelboam, 2015, Postural modification to the standard Valsalva manoeuvre for emergency treatment of supraventricular tachycardias (REVERT): a randomised controlled trial, Lancet source

In the paper

“The morphology criteria are not fulfilled in any lead in 4% of SVTs and 6% of VTs, and in a third of cases when one lead (V 1 or V 6 ) favours one diagnosis, the other one favours the opposite diagnosis (VT in one lead and SVT the other one and vice versa).59”

What the sources say

• Not checked yetcites [59] Brugada, 1991, A new approach to the differential diagnosis of a regular tachycardia with a wide QRS complex, Circulation source

In the paper

“Class Ic and Ia drugs cause use-dependent slowing of conduction, and class III drugs prolong refractoriness at His-Purkinje tissue more than in the ventricular myocardium.54,55”

What the sources say

• Not checked yetcites [54] Crijns, 1993, Sequential bilateral bundle branch block during dofetilide, a new class III antiarrhythmic agent, in a patient with atrial fibrillation, J Cardiovasc Electrophysiol source
• Not checked yetcites [55] Crijns, 1988, Supraventricular tachycardia mimicking ventricular tachycardia during flecainide treatment, Am J Cardiol source

In the paper

“Thus, electrocardiographic criteria may provide clues suggestive of typical, slow-fast AVNRT, but are of limited value for appropriate differential diagnosis.”

In the paper

“This pattern suggests VT with a specificity of more than 90%, but this criterion has low sensitivity being present in ,20% of all VTs.”

What the sources say

• Not checked yetcites [53] Alzand, 2011, Diagnostic criteria of broad QRS complex tachycardia: decades of evolution, Europace source

In the paper

“While positive concordance may occur during antidromic SVT using a left posterior or left lateral accessory pathway a negative concordance is nearly always VT. 53”

What the sources say

• Not checked yetcites [53] Alzand, 2011, Diagnostic criteria of broad QRS complex tachycardia: decades of evolution, Europace source

In the paper

“The advantages of adenosine relative to IV calcium channel are its rapid onset, the short half-life, and the avoidance of hypotension.71”

What the sources say

• Not checked yetcites [71] Delaney, 2011, The relative efficacy of adenosine versus verapamil for the treatment of stable paroxysmal supraventricular tachycardia in adults: a meta-analysis, Eur J Emerg Med source

In the paper

“The tachycardia tends to be persistent and most of the affected patients are young and female, but this disorder is not limited to that population.95”

What the sources say

• Not checked yetcites [95] Still, 2005, Prevalence, characteristics and natural course of inappropriate sinus tachycardia, Europace source

In the paper

“A taller right rabbit ear characterizes the RBBB aberrancy but does not exclude VT. 57”

What the sources say

• Not checked yetcites [57] Garner, 2013, Wide complex tachycardia—ventricular tachycardia or not ventricular tachycardia, that remains the question, Arrhythm Electrophysiol Rev source

In the paper

“In true LBBB, no Q wave is present in the lateral precordial leads.Therefore, the presence of any Q or QS wave in lead V6 favours VT. 56”

What the sources say

• Not checked yetcites [56] Wellens, 1978, The value of the electrocardiogram in the differential diagnosis of a tachycardia with a widened QRS complex, Am J Med source

In the paper

“There has been one report on the analysis of 267 wide-QRS tachycardias, consisting of VT and antidromic AVRT.The derived criteria were found to offer sensitivity of 75% and specificity of 100%, 63”

What the sources say

• Not checked yetcites [63] Steurer, 1994, The differential diagnosis on the electrocardiogram between ventricular tachycardia and preexcited tachycardia, Clin Cardiol source

In the paper

“as opposed to inappropriate sinus tachycardia, in POTS the tachycardia occurs gradually moving from supine to upright position in the absence of orthostatic hypotension.93”

What the sources say

• Not checked yetcites [93] Sheldon, 2015, 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope, Heart Rhythm source

In the paper

“These criteria are specific (91-100%) but modestly sensitive (58-14%).22”

What the sources say

• Not checked yetcites [22] Kalbfleisch, 1993, Differentiation of paroxysmal narrow QRS complex tachycardias using the 12-lead electrocardiogram, J Am Coll Cardiol source

In the paper

“the heart rate can shift suddenly at initiation of sinus node reentrant tachycardia, as opposed to the gradual increase of the inappropriate sinus tachycardia rate;”

What the sources say

• Not checked yetcites [92] Gomes, 1985, Sustained symptomatic sinus node reentrant tachycardia: incidence, clinical significance, electrophysiologic observations and the effects of antiarrhythmic agents, J Am Coll Cardiol source

In the paper

“Beta blockers and calcium-channel blockers may be effective and there is a low risk of side effects.113,114”

What the sources say

• Not checked yetcites [113] Mehta, 1988, Ectopic automatic atrial tachycardia in children: clinical characteristics, management and follow-up, J Am Coll Cardiol source
• Not checked yetcites [114] Yamabe, 2014, Demonstration of anatomic reentrant circuit in verapamil-sensitive atrial tachycardia originating from the atrioventricular annulus other than the vicinity of the atrioventricular node, Am J Cardiol source

In the paper

“Most studies reported no gender impact on prevalence.7”

What the sources say

• Not checked yetcites [7] Rodriguez, 1992, Age at onset and gender of patients with different types of supraventricular tachycardias, Am J Cardiol source

In the paper

“Multifocal atrial tachycardia is not a good indication for catheter ablation, and metoprolol has been found superior to verapamil, but should be used with caution as pulmonary disease is frequent in MAT (Table 11).106,117”

What the sources say

• Not checked yetcites [106] Arsura, 1988, A randomized, double-blind, placebo-controlled study of verapamil and metoprolol in treatment of multifocal atrial tachycardia, Am J Med source
• Not checked yetcites [117] Hazard, 1987, Treatment of multifocal atrial tachycardia with metoprolol, Crit Care Med source

In the paper

“In centrifugal arrhythmias, (such as focal AT and localized reentry) the activation originates from a source and spreads centrifugally to the rest of the atria, while in macro-reentries, it follows a large path around a central obstacle and reenters.18”

What the sources say

• Not checked yetcites [18] Jais, 2009, A deductive mapping strategy for atrial tachycardia following atrial fibrillation ablation: importance of localized reentry, J Cardiovasc Electrophysiol source

In the paper

“Complications of sinus node modification may occur in up to 14% of cases, and include cardiac tamponade, SVC syndrome, diaphragmatic paralysis due to phrenic nerve palsy, and sinus node dysfunction with the need for permanent pacing.88 -90”

What the sources say

• Not checked yetcites [88] Gianni, 2016, Catheter ablation of inappropriate sinus tachycardia, J Interv Card Electrophysiol source
• Not checked yetcites [89] Jacobson, 2014, Epicardial/endocardial sinus node ablation after failed endocardial ablation for the treatment of inappropriate sinus tachycardia, J Cardiovasc Electrophysiol source
• Not checked yetcites [90] Leonelli, 2000, Frequency of superior vena cava syndrome following radiofrequency modification of the sinus node and its management, Am J Cardiol source

In the paper

“In asymptomatic young people the prevalence of focal AT has been reported to be as low as 0.34%, with an increased prevalence of 0.46% in symptomatic patients.99”

What the sources say

• Not checked yetcites [99] Poutiainen, 1999, Prevalence and natural course of ectopic atrial tachycardia, Eur Heart J source

In the paper

“Verapamil, digoxin, and amiodarone have demonstrated variable success while beta-blockers are often ineffective, and the potential benefit of ivabradine is likely to be minimal.92,98”

What the sources say

• Not checked yetcites [92] Gomes, 1985, Sustained symptomatic sinus node reentrant tachycardia: incidence, clinical significance, electrophysiologic observations and the effects of antiarrhythmic agents, J Am Coll Cardiol source
• Not checked yetcites [98] Yusuf, 2003, Sinus tachyarrhythmias and the specific bradycardic agents: a marriage made in heaven?, J Cardiovasc Pharmacol Ther source

In the paper

“Class Ia, Ic, and III drugs may be effective if first-line therapy has failed, but Ia and Ic agents should be ideally combined associated with AV node blocking agents.107 -109,115,116”

What the sources say

• Not checked yetcites [107] Hohnloser, 1992, Short- and long-term efficacy and safety of flecainide acetate for supraventricular arrhythmias, Am J Cardiol source
• Not checked yetcites [108] Kunze, 1986, Effect of encainide and flecainide on chronic ectopic atrial tachycardia, J Am Coll Cardiol source
• Not checked yetcites [109] Coumel, 1980, Amiodarone in the treatment of cardiac arrhythmias in children: one hundred thirty-five cases, Am Heart J source
• Not checked yetcites [115] Heusch, 1994, Clinical experience with propafenone for cardiac arrhythmias in the young, Eur Heart J source
• Not checked yetcites [116] Colloridi, 1992, Oral sotalol in pediatric atrial ectopic tachycardia, Am Heart J source

In the paper

“AT is considered a benign condition, but cases of tachycardiomyopathy have been described.102”

What the sources say

• Not checked yetcites [102] Chen, 1998, Focal atrial tachycardia: reanalysis of the clinical and electrophysiologic characteristics and prediction of successful radiofrequency ablation, J Cardiovasc Electrophysiol source

In the paper

“Localized reentries are small reentrant circuits, with a diameter that is less than 2 -3 cm.118”

What the sources say

• Not checked yetcites [118] Jais, 2000, Mapping and ablation of left atrial flutters, Circulation source

In the paper

“The 24-h Holter monitoring characteristically demonstrates a mean HR .90bpm with an exaggerated HR response .100bpm during the waking hours.95”

What the sources say

• Not checked yetcites [95] Still, 2005, Prevalence, characteristics and natural course of inappropriate sinus tachycardia, Europace source

In the paper

“Intravenous adenosine has been shown to terminate AT, particularly when there is a focal origin, but the tachycardia may continue with AV block.103,105”

What the sources say

• Not checked yetcites [103] Markowitz, 1999, Differential effects of adenosine on focal and macroreentrant atrial tachycardia, J Cardiovasc Electrophysiol source
• Not checked yetcites [105] Kall, 1995, Adenosine-sensitive atrial tachycardia, Pacing Clin Electrophysiol source

In the paper

“Focal AT may arise from any site in both atria, but crista terminalis, tricuspid and mitral valve annulus, and within the thoracic veins joining to the atria, are sites of predilection.101”

What the sources say

• Not checked yetcites [101] Teh, 2009, Using the 12-lead ECG to localize the origin of ventricular and atrial tachycardias: part 1. Focal atrial tachycardia, J Cardiovasc Electrophysiol source

In the paper

“sinus node reentrant tachycardia is easily and reproducibly induced with programmed atrial stimulation differently from inappropriate sinus tachycardia;”

What the sources say

• Not checked yetcites [92] Gomes, 1985, Sustained symptomatic sinus node reentrant tachycardia: incidence, clinical significance, electrophysiologic observations and the effects of antiarrhythmic agents, J Am Coll Cardiol source

In the paper

“In a double-blind, randomized, placebo-controlled trial with a crossover design on 21 patients, 75% of inappropriate sinus tachycardia-related symptoms were eliminated in the ivabradine cohort, with nearly 50% of patients experiencing prompt and complete resolution of all symptoms in a short-term follow-up.85”

What the sources say

• Not checked yetcites [85] Cappato, 2012, Clinical efficacy of ivabradine in patients with inappropriate sinus tachycardia: a prospective, randomized, placebo-controlled, double-blind, crossover evaluation, J Am Coll Cardiol source

In the paper

“ivabradine, a selective If current blocker that directly slows the HR without influence on intraventricular conduction, contractility, or haemodynamics, has been found safe and effective in multiple small trials (Table 9).85,86”

What the sources say

• Not checked yetcites [85] Cappato, 2012, Clinical efficacy of ivabradine in patients with inappropriate sinus tachycardia: a prospective, randomized, placebo-controlled, double-blind, crossover evaluation, J Am Coll Cardiol source
• Not checked yetcites [86] Ptaszynski, 2013, Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy, Europace source

In the paper

“Atrial overdrive pacing can be used to localize the focus of these tachycardias, since the PPI increases with increasing distance from the source.100”

What the sources say

• Not checked yetcites [100] Mohamed, 2007, A novel pacing maneuver to localize focal atrial tachycardia, J Cardiovasc Electrophysiol source

In the paper

“In a more recent study of 20 patients, ivabradine had a similar effect on resting heart rate as metoprolol but was more effective in relieving symptoms during exercise or daily activity, and was better tolerated.86”

What the sources say

• Not checked yetcites [86] Ptaszynski, 2013, Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy, Europace source

In the paper

“Adenosine injection can help by terminating focal AT or by slowing the ventricular rate.103”

What the sources say

• Not checked yetcites [103] Markowitz, 1999, Differential effects of adenosine on focal and macroreentrant atrial tachycardia, J Cardiovasc Electrophysiol source

In the paper

“The reentry mechanism is supported by a line of conduction block in the posterior RA, extending from the IVC toward the SVC, most often related to anisotropic conduction at the crista terminalis, 123 although other structures of the posterior RA may also play a role.124”

What the sources say

• Not checked yetcites [123] Olgin, 1995, Role of right atrial endocardial structures as barriers to conduction during human type I atrial flutter. Activation and entrainment mapping guided by intracardiac echocardiography, Circulation source
• Not checked yetcites [124] Friedman, 2000, Global right atrial mapping of human atrial flutter: the presence of posteromedial (sinus venosa region) functional block and double potentials : a study in biplane fluoroscopy and intracardiac echocardiography, Circulation source

In the paper

“Amiodarone may not be very effective acutely to reestablish sinus rhythm, but it does help control ventricular rate if it is too fast.143,144”

What the sources say

• Not checked yetcites [143] Bianconi, 2000, Comparison of intravenously administered dofetilide versus amiodarone in the acute termination of atrial fibrillation and flutter. A multicentre, randomized, double-blind, placebo-controlled study, Eur Heart J source
• Not checked yetcites [144] Kafkas, 2007, Conversion efficacy of intravenous ibutilide compared with intravenous amiodarone in patients with recent-onset atrial fibrillation and atrial flutter, Int J Cardiol source

In the paper

“Systemic embolism occurs in AFL about 30% as frequently as in AF, 168 -170 a difference that disappears when AFL is associated with AF episodes.”

What the sources say

• Not checked yetcites [168] Biblo, 2001, Risk of stroke in patients with atrial flutter, Am J Cardiol source
• Not checked yetcites [169] Wood, 1997, Risk of thromboembolism in chronic atrial flutter, Am J Cardiol source
• Not checked yetcites [170] Seidl, 1998, Risk of thromboembolic events in patients with atrial flutter, Am J Cardiol source

In the paper

“This is a particularly difficult goal in AFL and even the combination of AV node blocking drugs (digoxin, b blockers, calcium channel blockers) 135 -137 may fail, making cardioversion to sinus rhythm necessary.”

What the sources say

• Not checked yetcites [135] Ellenbogen, 1991, A placebo-controlled trial of continuous intravenous diltiazem infusion for 24-hour heart rate control during atrial fibrillation and atrial flutter: a multicenter study, J Am Coll Cardiol source
• Not checked yetcites [136] Platia, 1989, Esmolol versus verapamil in the acute treatment of atrial fibrillation or atrial flutter, Am J Cardiol source
• Not checked yetcites [137] Salerno, 1989, Efficacy and safety of intravenous diltiazem for treatment of atrial fibrillation and atrial flutter. The Diltiazem-Atrial Fibrillation/Flutter Study Group, Am J Cardiol source

In the paper

“However, adenosine can produce a rebound increase of AV conduction to 1:1, and may also precipitate AF. 177,178”

What the sources say

• Not checked yetcites [177] Brodsky, 1994, Enhanced atrioventricular conduction during atrial flutter after intravenous adenosine, N Engl J Med source
• Not checked yetcites [178] Strickberger, 1997, Adenosine-induced atrial arrhythmia: a prospective analysis, Ann Intern Med source

In the paper

“In these cases with scar-related areas of block the ECG pattern may not Table 12 Therapy of atrial flutter/ macro-reentrant tachycardia Recommendation Reference Acute therapy Synchronised DC cardioversion is recommended for haemodynamically unstable patients with AFL/MRT a 131,132 IV anticoagulation may be considered in case emergency cardioversion is necessary.Anticoagulation should be continued”

What the sources say

• Not checked yetcites [159] Lukac, 2005, Ablation of atrial tachycardia after surgery for congenital and acquired heart disease using an electroanatomic mapping system: which circuits to expect in which substrate?, Heart Rhythm source
• Not checked yetcites [160] Coffey, 2013, Catheter ablation of scar-related atypical atrial flutter, Europace source
• Not checked yetcites [171] Bochoeyer, 2003, Surface electrocardiographic characteristics of right and left atrial flutter, Circulation source

In the paper

“Catheter ablation is reported to have a 75 -100% success rate, 111,120 and has been shown superior to antiarrhythmic drugs in a randomized study in the context of AF ablation.112”

What the sources say

• Not checked yetcites [111] Anguera, 2001, Outcomes after radiofrequency catheter ablation of atrial tachycardia, Am J Cardiol source
• Not checked yetcites [120] Hoffmann, 2002, Clinical experience with electroanatomic mapping of ectopic atrial tachycardia, Pacing Clin Electrophysiol source
• Not checked yetcites [112] Zhang, 2014, Optimal rhythm-control strategy for recurrent atrial tachycardia after catheter ablation of persistent atrial fibrillation: a randomized clinical trial, Eur Heart J source

In the paper

“If complete block is present, the superior turning point is the atrial roof, between the superior vena cava (SVC) and the tricuspid ring, but in other cases the turning point may be at different levels of the postero-lateral wall, across the crista terminalis.125 -127”

What the sources say

• Not checked yetcites [125] Cheng, 1999, Right atrial flutter due to lower loop reentry: mechanism and anatomic substrates, Circulation source
• Not checked yetcites [126] Dixit, 2011, Noncontact electroanatomic mapping to characterize typical atrial flutter: participation of right atrial posterior wall in the reentrant circuit, J Cardiovasc Electrophysiol source
• Not checked yetcites [127] Santucci, 2009, Electroanatomic mapping of postpacing intervals clarifies the complete active circuit and variants in atrial flutter, Heart Rhythm source

In the paper

“They are localized in one segment of the atrium and depend on a very slow conduction area showing a very long duration and fragmented signal which usually encompass more than half the cycle length and are the target for ablation.119”

What the sources say

• Not checked yetcites [119] Takahashi, 2009, Electrophysiological characteristics of localized reentrant atrial tachycardia occurring after catheter ablation of long-lasting persistent atrial fibrillation, J Cardiovasc Electrophysiol source

In the paper

“Multiple circuits are possible, including CTI-dependent AFL which still is the most common type even in these situations.11,159,160”

What the sources say

• Not checked yetcites [11] Granada, 2000, Incidence and predictors of atrial flutter in the general population, J Am Coll Cardiol source
• Not checked yetcites [159] Lukac, 2005, Ablation of atrial tachycardia after surgery for congenital and acquired heart disease using an electroanatomic mapping system: which circuits to expect in which substrate?, Heart Rhythm source
• Not checked yetcites [160] Coffey, 2013, Catheter ablation of scar-related atypical atrial flutter, Europace source

In the paper

“In patients with AFL lasting .48h the risk of thromboembolism would appear high at the time of cardioversion to sinus rhythm, either by DC shock, atrial stimulation or CTI ablation, 133,134 and anticoagulation is recommended as in AF.”

What the sources say

• Not checked yetcites [133] Grimm, 1997, Left atrial appendage ‘stunning’ after electrical cardioversion of atrial flutter: an attenuated response compared with atrial fibrillation as the mechanism for lower susceptibility to thromboembolic events, J Am Coll Cardiol source
• Not checked yetcites [134] Irani, 1997, Prevalence of thrombus, spontaneous echo contrast, and atrial stunning in patients undergoing cardioversion of atrial flutter. A prospective study using transesophageal echocardiography, Circulation source

In the paper

“Dofetilide and ibutilide, pure class III AADs, are very effective for interrupting AFL in intravenous administration, while Class Ia and Ic drugs have little or no effect.138 -142,149”

What the sources say

• Not checked yetcites [138] Crijns, 1994, Atrial flutter can be terminated by a class III antiarrhythmic drug but not by a class IC drug, Eur Heart J source
• Not checked yetcites [139] Falk, 1997, Intravenous dofetilide, a class III antiarrhythmic agent, for the termination of sustained atrial fibrillation or flutter. Intravenous Dofetilide Investigators, J Am Coll Cardiol source
• Not checked yetcites [140] Stambler, 1997, Antiarrhythmic actions of intravenous ibutilide compared with procainamide during human atrial flutter and fibrillation: electrophysiological determinants of enhanced conversion efficacy, Circulation source
• Not checked yetcites [141] Volgman, 1998, Conversion efficacy and safety of intravenous ibutilide compared with intravenous procainamide in patients with atrial flutter or fibrillation, J Am Coll Cardiol source
• Not checked yetcites [142] Vos, 1998, Superiority of ibutilide (a new class III agent) over DL-sotalol in converting atrial flutter and atrial fibrillation. The Ibutilide/Sotalol Comparator Study Group, Heart source
• Not checked yetcites [149] Singh, 2000, Efficacy and safety of oral dofetilide in converting to and maintaining sinus rhythm in patients with chronic atrial fibrillation or atrial flutter: the symptomatic atrial fibrillation investigative research on dofetilide (SAFIRE-D) study, Circulation source

In the paper

“the so called 'lower loop' circuit could be considered a variation of typical AFL in which the activation crosses the posterior RA and TC at a lower level than usual, and the ECG tends to show a typical AFL pattern.125”

What the sources say

• Not checked yetcites [125] Cheng, 1999, Right atrial flutter due to lower loop reentry: mechanism and anatomic substrates, Circulation source

In the paper

“Peri-mitral or roof-dependent MRT may occur in 4-20% of AF ablation cases, being higher with linear or fractionated electrogram ablation techniques.119,197,198”

What the sources say

• Not checked yetcites [119] Takahashi, 2009, Electrophysiological characteristics of localized reentrant atrial tachycardia occurring after catheter ablation of long-lasting persistent atrial fibrillation, J Cardiovasc Electrophysiol source
• Not checked yetcites [197] Wasmer, 2012, Incidence, characteristics, and outcome of left atrial tachycardias after circumferential antral ablation of atrial fibrillation, Heart Rhythm source
• Not checked yetcites [198] Rostock, 2013, Prognostic role of subsequent atrial tachycardias occurring during ablation of persistent atrial fibrillation: a prospective randomized trial, Circ Arrhythm Electrophysiol source

In the paper

“Two randomized studies have shown the superiority of catheter ablation over AAD in terms of AFL recurrence, quality of life, repeat hospitalization and AAD side effects.153,154”

What the sources say

• Not checked yetcites [153] Da Costa, 2006, Results from the Loire-Ardeche-Drome-Isere-Puy-de-Dome (LADIP) trial on atrial flutter, a multicentric prospective randomized study comparing amiodarone and radiofrequency ablation after the first episode of symptomatic atrial flutter, Circulation source
• Not checked yetcites [154] Natale, 2000, Prospective randomized comparison of antiarrhythmic therapy versus first-line radiofrequency ablation in patients with atrial flutter, J Am Coll Cardiol source

In the paper

“Atypical, surgery-related AFL/MRT often occurs years after the procedure, suggesting that an atrial remodelling process may be necessary to make reentry stable around the surgical obstacle.”

In the paper

“AF is more likely in patients having had AF episodes before ablation and in those with a dilated LA. 187”

What the sources say

• Not checked yetcites [187] Ellis, 2007, Incidence of atrial fibrillation post-cavotricuspid isthmus ablation in patients with typical atrial flutter: left-atrial size as an independent predictor of atrial fibrillation recurrence, J Cardiovasc Electrophysiol source

In the paper

“The ECG pattern is difficult to relate to the mechanism, since slow conduction segments in reentry pathways may produce isoelectric lines and the atrial waves may reflect activation outside the circuit.171”

What the sources say

• Not checked yetcites [171] Bochoeyer, 2003, Surface electrocardiographic characteristics of right and left atrial flutter, Circulation source

In the paper

“Complete, persistent, bidirectional CTI block is the procedure endpoint, and, if attained, recurrence of the arrhythmia is seen in ,10% of cases.181,182”

What the sources say

• Not checked yetcites [181] Shah, 2000, Differential pacing for distinguishing block from persistent conduction through an ablation line, Circulation source
• Not checked yetcites [182] Schwartzman, 1996, Conduction block in the inferior vena caval-tricuspid valve isthmus: association with outcome of radiofrequency ablation of type I atrial flutter, J Am Coll Cardiol source

In the paper

“In patients with complex congenital heart disease undergoing the Mustard, Senning, or Fontan procedures, complex suture lines and large areas of myocardial damage create multiple substrates while in many cases the CTI is still a critical isthmus in the reentry circuit, with a difficult access for ablation.195,196”

What the sources say

• Not checked yetcites [195] Collins, 2000, Location of acutely successful radiofrequency catheter ablation of intraatrial reentrant tachycardia in patients with congenital heart disease, Am J Cardiol source
• Not checked yetcites [196] Zrenner, 2003, Delineation of intra-atrial reentrant tachycardia circuits after mustard operation for transposition of the great arteries using biatrial electroanatomic mapping and entrainment mapping, J Cardiovasc Electrophysiol source

In the paper

“MRT circuits may turn around the SVC and the upper portions of the crista terminalis ('upper loop') or around a lateral RA surgical scar or a septal patch.159,194”

What the sources say

• Not checked yetcites [159] Lukac, 2005, Ablation of atrial tachycardia after surgery for congenital and acquired heart disease using an electroanatomic mapping system: which circuits to expect in which substrate?, Heart Rhythm source
• Not checked yetcites [194] Kall, 2000, Atypical atrial flutter originating in the right atrial free wall, Circulation source

In the paper

“Dofetilide is moderately effective in cardioverting AF or AFL to SR, and significantly effective in maintaining SR but in-hospital initiation and dosage adjustment based on QTc and renal function are necessary to minimize a small but not negligible proarrhythmic risk.149”

What the sources say

• Not checked yetcites [149] Singh, 2000, Efficacy and safety of oral dofetilide in converting to and maintaining sinus rhythm in patients with chronic atrial fibrillation or atrial flutter: the symptomatic atrial fibrillation investigative research on dofetilide (SAFIRE-D) study, Circulation source

In the paper

“Complications of CTI ablation are infrequent, and usually limited to the vascular access, although a 0.17% in-hospital mortality has been reported.161”

What the sources say

• Not checked yetcites [161] Patel, 2016, Contemporary utilization and safety outcomes of catheter ablation of atrial flutter in the United States: analysis of 89,638 procedures, Heart Rhythm source

In the paper

“However, post-ablation prognosis is affected by the incidence of AF that can be 30 -50% in the long term (5-8 years).175”

What the sources say

• Not checked yetcites [175] Luria, 2008, Effect of radiofrequency ablation of atrial flutter on the natural history of subsequent atrial arrhythmias, J Cardiovasc Electrophysiol source

In the paper

“This high incidence has been related to inflammatory changes in the atrial myocardium, 213 not unlike the experimental pericarditis animal models, and it may be prevented by anti-inflammatory corticosteroid or colchicine treatment.214”

What the sources say

• Not checked yetcites [213] Ishii, 2005, Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation, Circulation source
• Not checked yetcites [214] Ho, 2009, Benefits and risks of corticosteroid prophylaxis in adult cardiac surgery: a dose-response meta-analysis, Circulation source

In the paper

“After AF 'maze' surgery, MRT may depend on breaks of the surgical ablation lines that can be localized by endocardial mapping allowing interruption of the MRT by localized ablation at these sites.201,202”

What the sources say

• Not checked yetcites [201] Akar, 2007, Surface electrocardiographic patterns and electrophysiologic characteristics of atrial flutter following modified radiofrequency MAZE procedures, J Cardiovasc Electrophysiol source
• Not checked yetcites [202] McElderry, 2008, Proarrhythmic aspects of atrial fibrillation surgery: mechanisms of postoperative macroreentrant tachycardias, Circulation source

In the paper

“However, these techniques carry a potentially increased risk of macroreentrant or focal iatrogenic atrial tachycardias, 197,207 and their value is rather not established in patients with paroxysmal or persistent AF. 208 -210”

What the sources say

• Not checked yetcites [197] Wasmer, 2012, Incidence, characteristics, and outcome of left atrial tachycardias after circumferential antral ablation of atrial fibrillation, Heart Rhythm source
• Not checked yetcites [207] O'Neill, 2009, Long-term follow-up of persistent atrial fibrillation ablation using termination as a procedural endpoint, Eur Heart J source
• Not checked yetcites [208] McLellan, 2015, A minimal or maximal ablation strategy to achieve pulmonary vein isolation for paroxysmal atrial fibrillation: a prospective multi-centre randomized controlled trial (the Minimax study), Eur Heart J source
• Not checked yetcites [209] Verma, 2015, Catheter Ablation for Persistent Atrial Fibrillation, N Engl J Med
• Not checked yetcites [210] Vogler, 2015, Pulmonary vein isolation versus defragmentation: the CHASE-AF clinical trial, J Am Coll Cardiol source

In the paper

“Atypical AFL/MRT ablation can be very challenging and has a lower success rate and a higher recurrence rate than CTI ablation.163,164,204 -206”

What the sources say

• Not checked yetcites [163] Bai, 2007, Radiofrequency ablation of atypical atrial flutter after cardiac surgery or atrial fibrillation ablation: a randomized comparison of open-irrigation-tip and 8-mm-tip catheters, Heart Rhythm source
• Not checked yetcites [164] Matsuo, 2010, Peri-mitral atrial flutter in patients with atrial fibrillation ablation, Heart Rhythm source
• Not checked yetcites [204] Miyazaki, 2015, Recurrent spontaneous clinical perimitral atrial tachycardia in the context of atrial fibrillation ablation, Heart Rhythm source
• Not checked yetcites [205] Aktas, 2010, Higher rate of recurrent atrial flutter and atrial fibrillation following atrial flutter ablation after cardiac surgery, J Cardiovasc Electrophysiol source
• Not checked yetcites [206] Bai, 2012, Ablation of perimitral flutter following catheter ablation of atrial fibrillation: impact on outcomes from a randomized study (PROPOSE), J Cardiovasc Electrophysiol source

In the paper

“Non-invasive approaches for orthodromic AVRT with vagal manoeuvres, including Valsalva and carotid sinus massage, could represent the first-line treatment with a success rate of approximately 50% (Table 16).66 -68”

What the sources say

• Not checked yetcites [66] Lim, 1998, Comparison of treatment of supraventricular tachycardia by Valsalva maneuver and carotid sinus massage, Ann Emerg Med source
• Not checked yetcites [67] Smith, 2015, Effectiveness of the Valsalva Manoeuvre for reversion of supraventricular tachycardia, Cochrane Database Syst Rev
• Not checked yetcites [68] Wen, 1998, Electrophysiological mechanisms and determinants of vagal maneuvers for termination of paroxysmal supraventricular tachycardia, Circulation source

In the paper

“This would suggest that some kind of remodelling or maturation process may be necessary before a MRT tachycardia circuit becomes stable, and that a new ablation procedure early after AF ablation should not be indicated, unless tachycardia does not respond to antiarrhythmic drugs.”

In the paper

“In post-AF ablation AFL, more than one tachycardia mechanisms often coexist, both MRT and focal, 157,203 making sometimes difficult to identify the circuits' structures, particularly when entrainment manoeuvres result in changes in activation.”

What the sources say

• Not checked yetcites [157] Chae, 2007, Atrial tachycardia after circumferential pulmonary vein ablation of atrial fibrillation: mechanistic insights, results of catheter ablation, and risk factors for recurrence, J Am Coll Cardiol source
• Not checked yetcites [203] Gerstenfeld, 2004, Mechanisms of organized left atrial tachycardias occurring after pulmonary vein isolation, Circulation source

In the paper

“Thus, multiple sources of cells that participate in the AV node may play a role in its heterogeneity, and form the substrate underlying AV nodal reentrant tachycardia.”

In the paper

“The incidence of atrial arrhythmias in the early postoperative period (days) after coronary artery by-pass surgery, is 20-30%.212”

What the sources say

• Not checked yetcites [212] Frost, 1992, Atrial fibrillation and flutter after coronary artery bypass surgery: epidemiology, risk factors and preventive trials, Int J Cardiol source

In the paper

“In many patients attacks indeed manifest early in life, whereas in a substantial proportion of patients AVNRT starts only in the 4th or 5th decade.223”

What the sources say

• Not checked yetcites [223] Pentinga, 1993, Late onset atrioventricular nodal tachycardia, Int J Cardiol source

In the paper

“There is very little evidence regarding indications for anticoagulation in patients with atypical FL/ MRT of the RA, but the associated heart disease could make embolic risk higher, making anticoagulation, as proposed above, a reasonable alternative.”

In the paper

“although the majority of APs conduct both anterogradely and retrogradely ( 60%), some of them are able of propagating impulses in only one direction.Those that conduct in the anterograde direction only are uncommon (,5%), whereas those that conduct in the retrograde direction only are more frequent (17-37%).303”

What the sources say

• Not checked yetcites [303] Issa, 2012, Atrioventricular reentrant tachycardia source

In the paper

“The AV node is a three-dimensional structure with greater variability in the space constant of tissue, and poor gap junction connectivity due to differential expression of connexin isoforms, conditions that provide an explanation of dual conduction and nodal reentrant arrhythmogenesis.218,219”

What the sources say

• Not checked yetcites [218] Nikolaidou, 2012, Structure-function relationship in the sinus and atrioventricular nodes, Pediatr Cardiol source
• Not checked yetcites [219] Hucker, 2008, Connexin 43 expression delineates two discrete pathways in the human atrioventricular junction, Anat Rec (Hoboken) source

In the paper

“In the general population, the prevalence of WPW pattern on surface ECG is from 0.15% to 0.25%, 304 increasing to 0.55% among first-degree relatives of affected patients.305”

What the sources say

• Not checked yetcites [304] Krahn, 1992, The natural history of electrocardiographic preexcitation in men. The Manitoba Follow-up Study, Ann Intern Med source
• Not checked yetcites [305] Vidaillet, 1987, Familial occurrence of accessory atrioventricular pathways (preexcitation syndrome), N Engl J Med source

In the paper

“In early studies, identified predictors of ventricular fibrillation in patients with WPW syndrome were R-R interval during spontaneous or induced AF , 180 ms, history of symptomatic tachycardia and inducibility of AVRT, and multiple accessory pathways.308,309”

What the sources say

• Not checked yetcites [308] Beckman, 1990, The predictive value of electrophysiologic studies in untreated patients with Wolff-Parkinson-White syndrome, J Am Coll Cardiol source
• Not checked yetcites [309] Montoya, 1991, Ventricular fibrillation in the Wolff-Parkinson-White syndrome, Eur Heart J source

In the paper

“Type II AFL is likely related to the functional reentrant rhythms induced by rapid pacing under acetylcholine in the dog, and in most cases is probably a laboratory, pacing-induced artefact of little clinical significance.”

In the paper

“Heterogeneity of both fast and slow conduction patterns has been well described, and all forms of AVNRT may display anterior, posterior and middle or even left atrial retrograde activation patterns.228”

What the sources say

• Not checked yetcites [228] Katritsis, 2010, Atrioventricular nodal reentrant tachycardia, Circulation source

In the paper

“Tachycardia inducibility at the end of the procedure is not predictive of the long-term occurrence of MRT, and most of tachycardias appearing in the initial 6-8 weeks of follow-up disappear under AAD.158,193”

What the sources say

• Not checked yetcites [158] Daoud, 2006, Proarrhythmia of circumferential left atrial lesions for management of atrial fibrillation, J Cardiovasc Electrophysiol source
• Not checked yetcites [193] Chugh, 2005, Prevalence, mechanisms, and clinical significance of macroreentrant atrial tachycardia during and following left atrial ablation for atrial fibrillation, Heart Rhythm source

In the paper

“The superior transseptal surgical approach to mitral valve repair or replacement is more arrhythmogenic than direct posterior LA atriotomy, leading to the appearance of MRT circuits involving both atria, and that are difficult to eliminate by ablation.160,200”

What the sources say

• Not checked yetcites [160] Coffey, 2013, Catheter ablation of scar-related atypical atrial flutter, Europace source
• Not checked yetcites [200] Lukac, 2006, The superior transseptal surgical approach to mitral valve creates slow conduction, Pacing Clin Electrophysiol source

In the paper

“A posteroseptal location of accessory pathways was found in almost all patients with VF, whereas the rate of multiple accessory pathways was similar in patients with or without VF, as reported by other investigators.335”

What the sources say

• Not checked yetcites [335] Timmermans, 1995, Aborted sudden death in the Wolff-Parkinson-White syndrome, Am J Cardiol source

In the paper

“Benign arrhythmias including AVRT and AF developed in 15.6%, while 21.6% of older patients (median age, 42 years) lost ventricular preexcitation remaining asymptomatic.322”

What the sources say

• Not checked yetcites [322] Pappone, 2014, Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients, Circulation source

In the paper

“Although these rates are higher than most experienced electrophysiologists have in daily practice, in the latest meta-analysis AVRT still carried a mortality rate of 0.1% after radiofrequency ablation, whereas there was no procedural-related mortality for AFL or AVNRT.244”

What the sources say

• Not checked yetcites [244] Spector, 2009, Meta-analysis of ablation of atrial flutter and supraventricular tachycardia, Am J Cardiol source

In the paper

“Asymptomatic patients who developed VF had short accessory pathway anterograde ERP less than 200 -220 ms, and a shorter pre-excited RR interval during AF (SPERRI) less than 200 -230 ms.339,341”

What the sources say

• Not checked yetcites [339] Pappone, 2003, Usefulness of invasive electrophysiologic testing to stratify the risk of arrhythmic events in asymptomatic patients with Wolff-Parkinson-White pattern: results from a large prospective long-term follow-up study, J Am Coll Cardiol source
• Not checked yetcites [341] Santinelli, 2009, Asymptomatic ventricular preexcitation: a long-term prospective follow-up study of 293 adult patients, Circ Arrhythm Electrophysiol source

In the paper

“The 5-year Kaplan -Meier estimates of the incidence of arrhythmic events were 7% among patients who underwent ablation, and 77% among the controls (P , 0.001 by the log-rank test); the risk reduction with ablation was 92% (relative risk, 0.08; 95% CI, 0.02 to 0.33; P , 0.001).”

What the sources say

• Not checked yetcites [343] Pappone, 2003, A randomized study of prophylactic catheter ablation in asymptomatic patients with the Wolff-Parkinson-White syndrome, N Engl J Med source

In the paper

“Concealed pathways are more frequently localized along the left free wall (64%), and less frequently at septal (31%) and right free wall locations.327”

What the sources say

• Not checked yetcites [327] Kuck, 1990, Sites of conduction block in accessory atrioventricular pathways. Basis for concealed accessory pathways, Circulation source

In the paper

“In a recent review, data from observational studies on 833 patients who did not undergo ablation showed that up to 9% of patients developed malignant arrhythmias, and up to 2% developed VF during follow-up.344”

What the sources say

• Not checked yetcites [344] Al-Khatib, 2016, Risk stratification for arrhythmic events in patients with asymptomatic pre-excitation: a systematic review for the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society, J Am Coll Cardiol source

In the paper

“During follow-up, 1 child in the ablation group (5%), and 12 in the control group (44%) had arrhythmic events.Two children in the control group had ventricular fibrillation, and one died suddenly.”

What the sources say

• Not checked yetcites [345] Pappone, 2004, Radiofrequency ablation in children with asymptomatic Wolff-Parkinson-White syndrome, N Engl J Med source

In the paper

“In an 8-year prospective study on 2169 symptomatic or asymptomatic WPW patients, electrophysiologic testing revealed that patients who developed VF, showed more inducible pre-excited sustained AF triggered by AV reciprocating tachycardia (73.3% vs. 44.9%),and shorter median accessory pathway ERP (220 vs. 240 ms) than subjects not experiencing ventricular arrhythmias.322”

What the sources say

• Not checked yetcites [322] Pappone, 2014, Wolff-Parkinson-White syndrome in the era of catheter ablation: insights from a registry study of 2169 patients, Circulation source

In the paper

“Complications related to EP study developed in three patients (1%) (2 pneumothorax and 1 large femoral haematoma).An ablation-related complication (permanent RBBB) developed in 1 (3%) of 37 patients.343”

What the sources say

• Not checked yetcites [343] Pappone, 2003, A randomized study of prophylactic catheter ablation in asymptomatic patients with the Wolff-Parkinson-White syndrome, N Engl J Med source

In the paper

“The second randomized study was conducted on asymptomatic children (age range, 5 to 12 years) with WPW syndrome and in whom AVRT or AF were reproducibly inducible.After randomization of 60 children, but before any ablation had been performed, the parents withdrew 13 of them from the study.Of the remaining children, 20 underwent prophylactic ablation and 27 had no treatment.”

What the sources say

• Not checked yetcites [345] Pappone, 2004, Radiofrequency ablation in children with asymptomatic Wolff-Parkinson-White syndrome, N Engl J Med source

In the paper

“Mahaim conduction is usually antegrade only, but concealed fibres have also been described.332”

What the sources say

• Not checked yetcites [332] Hluchy, 1999, Radiofrequency ablation of a concealed nodoventricular Mahaim fiber guided by a discrete potential, J Cardiovasc Electrophysiol source

In the paper

“Moreover, no gender predilection was found and these pathways tend to occur more frequently in younger patients than in those with AVNRT; however significant overlap exists.303”

What the sources say

• Not checked yetcites [303] Issa, 2012, Atrioventricular reentrant tachycardia source

In the paper

“In a large retrospective series of 690 WPW patients, 15 (2.2%) had aborted sudden death, and in 8 of them (.50%) VF was the first clinical manifestation of the syndrome.335”

What the sources say

• Not checked yetcites [335] Timmermans, 1995, Aborted sudden death in the Wolff-Parkinson-White syndrome, Am J Cardiol source

In the paper

“The 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia report major complication rates after radiofrequency catheter ablation of 3.0% and 2.8% for AVNRT and AVRT, respectively.2”

What the sources say

• Not checked yetcites [2] Page, 2016, 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society, J Am Coll Cardiol source

In the paper

“Small trials have reported the safety and efficacy of this drug therapy in the context of WPW syndrome, 323,324 but no randomized trials in this setting have been performed.”

What the sources say

• Not checked yetcites [323] Breithardt, 1984, Effect of propafenone in the Wolff-Parkinson-White syndrome: electrophysiologic findings and long-term follow-up, Am J Cardiol source
• Not checked yetcites [324] Vassiliadis, 1990, Propafenone in the prevention of non-ventricular arrhythmias associated with the Wolff-Parkinson-White syndrome, Int J Cardiol source

In the paper

“Permanent Junctional Reciprocating Tachycardia (PJRT) represents a rare form of atrioventricular reciprocating tachycardia using a concealed accessory pathway, usually located in the posteroseptal region, with retrograde decremental conduction properties.328”

What the sources say

• Not checked yetcites [328] Kang, 2014, Permanent junctional reciprocating tachycardia in children: a multicenter experience, Heart Rhythm source

In the paper

“Mahaim fibers are nodoventricular (as initially described) or atriofascicular (more often) decrementally conducting connections between the right atrium or the AV node and the right ventricle in or close to the right bundle branch.329 -332”

What the sources say

• Not checked yetcites [329] Kottkamp, 1996, Variants of preexcitation--specialized atriofascicular pathways, nodofascicular pathways, and fasciculoventricular pathways: electrophysiologic findings and target sites for radiofrequency catheter ablation, J Cardiovasc Electrophysiol source
• Not checked yetcites [330] Gandhavadi, 2013, Characterization of the distal insertion of atriofascicular accessory pathways and mechanisms of QRS patterns in atriofascicular antidromic tachycardia, Heart Rhythm source
• Not checked yetcites [331] Haissaguerre, 1995, Characteristics of the ventricular insertion sites of accessory pathways with anterograde decremental conduction properties, Circulation source

In the paper

“The cumulative rate of arrhythmic events was lower among children at high risk who underwent ablation than among those at high risk who did not.The reduction in risk associated with ablation remained significant after adjustment in a Cox regression analysis.”

What the sources say

• Not checked yetcites [345] Pappone, 2004, Radiofrequency ablation in children with asymptomatic Wolff-Parkinson-White syndrome, N Engl J Med source

In the paper

“In recent years, trans-baffle access has been described, and was successful in 96% of 74 attempted cases and does not seem to be associated with a higher incidence of adverse events.361”

What the sources say

• Not checked yetcites [361] Correa, 2013, Transbaffle mapping and ablation for atrial tachycardias after mustard, senning, or Fontan operations, J Am Heart Assoc source

In the paper

“Incisional related AFL is common (20%) as is sustained VT (11%) and risk of SCD (8%).387,388”

What the sources say

• Not checked yetcites [387] Gatzoulis, 2000, Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study, Lancet source
• Not checked yetcites [388] Biviano, 2010, Atrial flutter catheter ablation in adult patients with repaired tetralogy of Fallot: mechanisms and outcomes of percutaneous catheter ablation in a consecutive series, J Interv Card Electrophysiol source

In the paper

“The acute success rates of catheter ablation procedures of SVT in ACHD patients ranges from 65 to 100%, with a higher recurrence rate, 20 -60% within 2 years, than seen in other cohorts for routine SVT ablation.362 -364,379”

What the sources say

• Not checked yetcites [362] de Groot, 2010, Long-term outcome after ablative therapy of postoperative atrial tachyarrhythmia in patients with congenital heart disease and characteristics of atrial tachyarrhythmia recurrences, Circ Arrhythm Electrophysiol source
• Not checked yetcites [363] Yap, 2010, Outcome of intra-atrial re-entrant tachycardia catheter ablation in adults with congenital heart disease: negative impact of age and complex atrial surgery, J Am Coll Cardiol source
• Not checked yetcites [364] Wu, 2013, Acute and long-term outcome after catheter ablation of supraventricular tachycardia in patients after the Mustard or Senning operation for D-transposition of the great arteries, Europace source

In the paper

“Respiratory arrest and femoral vein thrombosis were seen in two patients, while ablation-related complications were seen in three patients (RBBB, transient AV block and pericardial effusion).345”

What the sources say

• Not checked yetcites [345] Pappone, 2004, Radiofrequency ablation in children with asymptomatic Wolff-Parkinson-White syndrome, N Engl J Med source

In the paper

“Atrial tachycardias and impaired ventricular function are important and consistent risk factors for SCD in patients with CHD, of which corrected Tetralogy of Fallot, post-atrial switch operation Mustard or Senning, left heart obstructed lesions and univentricular hearts have the highest (2 -9% per decade) risk of SCD.352 -354”

What the sources say

• Not checked yetcites [352] Koyak, 2012, Sudden cardiac death in adult congenital heart disease, Circulation source
• Not checked yetcites [353] Nieminen, 2007, Causes of late deaths after pediatric cardiac surgery: a population-based study, J Am Coll Cardiol source
• Not checked yetcites [354] Gallego, 2012, Incidence and predictors of sudden cardiac arrest in adults with congenital heart defects repaired before adult life, Am J Cardiol source

In the paper

“In patients with repaired ASD, both CTI-dependent and 'incisional' AFL can occur and coexist in the same patient.349”

What the sources say

• Not checked yetcites [349] Wasmer, 2013, Isthmus-dependent right atrial flutter as the leading cause of atrial tachycardias after surgical atrial septal defect repair, Int J Cardiol source

In the paper

“Long-term outcomes after secundum ASD closure using transcatheter closure and surgical closure are excellent without significant differences with regard to atrial arrhythmias (9.3%), survival, or thromboembolism.382”

What the sources say

• Not checked yetcites [382] Kutty, 2012, Long-term (5- to 20-year) outcomes after transcatheter or surgical treatment of hemodynamically significant isolated secundum atrial septal defect, Am J Cardiol source