Junctional Tachycardia: A Critical Reassessment.

Humans Atrial Fibrillation Electrophysiologic Techniques, Cardiac / methods Tachycardia, Ectopic Junctional / diagnosis Atrioventricular Node Bundle of His Tachycardia, Atrioventricular Nodal Reentry / diagnosis Tachycardia, Supraventricular
atrioventricular nodal re-entry entrainment infra-atrial tachycardia junctional tachycardia pacing maneuvers

Journal

JACC. Clinical electrophysiology
ISSN: 2405-5018
Titre abrégé: JACC Clin Electrophysiol
Pays: United States
ID NLM: 101656995

Informations de publication

Date de publication:
03 2023
Historique:
received: 28 07 2022
revised: 17 10 2022
accepted: 26 10 2022
medline: 31 3 2023
entrez: 29 3 2023
pubmed: 30 3 2023
Statut: ppublish

Résumé

Junctional tachycardia (JT) is typically considered to have an automatic mechanism originating from the distal atrioventricular node. When there is 1:1 retrograde conduction via the fast pathway, JT would resemble the typical form of atrioventricular nodal re-entrant tachycardia (AVNRT). Atrial pacing maneuvers have been proposed to exclude AVNRT and suggest a diagnosis of JT. However, after excluding AVNRT, one should consider the possibility of an infra-atrial narrow QRS re-entrant tachycardia, which can exhibit features that resemble AVNRT as well as JT. Pacing maneuvers and mapping techniques should be performed to assess for infra-atrial re-entrant tachycardia before concluding that JT is the mechanism of a narrow QRS tachycardia. Distinguishing JT from typical AVNRT or infra-atrial re-entrant tachycardia has notable implications regarding the approach to ablation of the tachycardia. Ultimately, a contemporary review of the evidence on JT raises some questions as to the mechanism and source of what has traditionally been considered JT.

Identifiants

DOI: 10.1016/j.jacep.2022.10.040 PMID: 36990601
pubmed: 36990601
pii: S2405-500X(22)01068-4
doi: 10.1016/j.jacep.2022.10.040
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

425-441

Informations de copyright

Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Patrick Tchou (P)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: tchoup@ccf.org.

David Nemer (D)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Walid Saliba (W)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Niraj Varma (N)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Peter Aziz (P)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Akash Patel (A)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Hiroshi Nakagawa (H)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Mohamed Kanj (M)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Ayman Hussein (A)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Mandeep Bhargava (M)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Oussama Wazni (O)

Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Techniques électrophysiologiques cardiaques › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Tachycardie › Tachycardie supraventriculaire › Tachycardie jonctionnelle ectopique › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › Système cardiovasculaire › Coeur › Système de conduction du coeur › Noeud atrioventriculaire › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › Système cardiovasculaire › Coeur › Système de conduction du coeur › Faisceau de His › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Tachycardie › Tachycardie réciproque › Tachycardie par réentrée intranodale › Junctional Tachycardia: A Critical Reassessment.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Tachycardie › Tachycardie supraventriculaire › Junctional Tachycardia: A Critical Reassessment.