Atriyoventriküler nodal reenteran taşikardi: Patofizyolojiden tedaviye

Osman Yontar; İzzet Tandoğan

Atriyoventriküler nodal reenteran taşikardi: Patofizyolojiden tedaviye

Year 2012, Volume: 34 Issue: 3, 376 - 379, 21.12.2012

Osman Yontar , İzzet Tandoğan

Abstract

Özet

Supraventriküler taşikardiler; tüm yaş gruplarını etkileyebilen, yaşam kalitesini kayda değer derecede kötüleştirebilen bir hastalık grubudur. Bu grupta sınıflandırılan taşikardi tipleri arasında en sık gözleneni Atriyoventriküler Nodal Reenteran Taşikardi olarak tespit edilmiştir. Derlememizin amacı, sık gözlenen bu aritminin oluş mekanizmalarını ve tedavisini kısa ancak anlaşılır bir şekilde özetleyebilmektir.

Anahtar sözcükler: Supraventriküler taşikardi, yeniden giriş, ikili AV yolak

Abstract

Supraventricular tacycardias are a group of arrhytmias which may affect all age groups and cause remarkable recession in life quality. Atrioventricular nodal reentry tachycardia is the most common observed arrhythmia in this group. Aim of current review is to summarize the pathophysiologial basis and treatment methods in a brief and perceptible way.

Keywords: Supraventricular tachycardia, reentry, dual AV pathway

Keywords

References

U.S. Department of Health & Human Services (DHHS): Centers for Disease Control Vital and Health Statistics. National Hospital Discharge Survey: annual summary with detailed diagnosis and procedure data (1999). DHHS Publication No. (PHS) 2001; 2001-1722.
Orejarena LA, Vidaillet H Jr, DeStefano F, Nordstrom DL, Vierkant RA, Smith PN, Hayes JJ. Paroxysmal supraventricular tachycardia in the general population. J Am Coll Cardiol 1998; 31: 150-7.
Porter MJ, Morton JB, Denman R, Lin AC, Tierney S, Santucci PA, Cai JJ, Madsen N, Wilber DJ. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm 2004; 1: 393-6.
Mines GR. On dynamic equilibrium in the heart. J Physiol 1913; 46: 349-83.
Iliescu CC, Sebastiani A. Notes on the effects of quinidine upon paroxysms of tachycardia. Heart 1923; 10: 223-30.
Barker PS, Wilson FN, Johnston FD. The mechanism of auricular paroxysmal tachycardia. Am Heart J 1943; 26: 435-45.
Moe GK, Preston JB, Burlington H. Physiologic evidence for a dual A-V transmission system. Circ Res 1956; 4: 357-75.
Mendez C, Moe GK. Demonstration of a dual A-V nodal conduction system in the isolated rabbit heart. Circ Res 1966; 19: 378-93.
Goldreyer BN, Bigger JT Jr. Site of reentry in paroxysmal supraventricular tachycardia in man. Circulation 1971; 43: 15-26.
Lev M, Widran J, Erickson EE. A method for the histopathologic study of the atrioventricular node, bundle, and branches. AMA Arch Pathol 1951; 52: 73-83.
Widran J, Lev M. The dissection of the atrioventricular node, bundle and bundle branches in the human heart. Circulation 1951; 4: 863-7.
Anderson RH, Ho SY. The architecture of the sinus node, the atrioventricular conduction axis, and the internodal atrial myocardium. J Cardiovasc Electrophysiol 1998; 9: 1233-48.
Wu D, Yeh SJ, Wang CC, Wen MS, Chang HJ, Lin FC. Nature of dual atrioventricular node pathways and the tachycardia circuit as defined by radiofrequency ablation technique. J Am Coll Cardiol 1992; 20: 884-95.
Keim S, Werner P, Jazayeri M, Akhtar M, Tchou P. Localization of the fast and slow pathways in atrioventricular nodal reentrant tachycardia by intraoperative ice mapping. Circulation 1992; 86: 919-25.
Spach MS, Josephson ME. Initiating reentry: the role of nonuniform anisotropy in small circuits. J Cardiovasc Electrophysiol 1994; 5: 182-209.
Waxman MB, Wald RW, Sharma AD, Huerta F, Cameron DA. Vagal techniques for termination of paroxysmal supraventricular tachycardia. Am J Cardiol 1980; 46: 655-64.
Waxman MB, Bonet JF, Finley JP, Wald RW. Effects of respiration and posture on paroxysmal supraventricular tachycardia. Circulation 1980; 62: 1011-20.
DiMarco JP, Miles W, Akhtar M, Milstein S, Sharma AD, Platia E, McGovern B, Scheinman MM, Govier WC. Adenosine for paroxysmal supraventricular tachycardia: dose ranging and comparison with verapamil. Assessment in placebo-controlled, multicenter trials. The Adenosine for PSVT Study Group. Ann Intern Med 1990; 113: 104-10.
Huycke EC, Sung RJ, Dias VC, Milstein S, Hariman RJ, Platia EV. Intravenous diltiazem for termination of reentrant supraventricular tachycardia: a placebocontrolled, randomized, double-blind, multicenter study. J Am Coll Cardiol 1989; 13: 538-44.
Yeh SJ, Kou HC, Lin FC, Hung JS, Wu D. Effects of oral diltiazem in paroxysmal supraventricular tachycardia. Am J Cardiol 1983; 52: 271-8.
Epstein LM, Scheinman MM, Langberg JJ, Chilson D, Goldberg HR, Griffin JC. Percutaneous catheter modification of the atrioventricular node. A potential cure for atrioventricular nodal reentrant tachycardia. Circulation 1989; 80: 757-68.
Jazayeri MR, Hempe SL, Sra JS, Dhala AA, Blanck Z, Deshpande SS, Avitall B, Krum DP, Gilbert CJ, Akhtar M. Selective transcatheter ablation of the fast and slow pathways using radiofrequency energy in patients with atrioventricular nodal reentrant tachycardia. Circulation 1992; 85: 1318-28.
Spector P, Reynolds MR, Calkins H, Sondhi M, Xu Y, Martin A, Williams CJ, Sledge I. Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. Am J Cardiol 2009; 104: 671-7.
Steven D, Rostock T, Hoffmann BA, Servatius H, Drewitz I, Müllerleile K, Klemm H, Melchert C, Wegscheider K, Meinertz T, Willems S. Favorable outcome using an abbreviated procedure for catheter ablation of AVNRT: results from a prospective randomized trial. J Cardiovasc Electrophysiol 2009; 20: 522-5.
Clague JR, Dagres N, Kottkamp H, Breithardt G, Borggrefe M. Targeting the slow pathway for atrioventricular nodal reentrant tachycardia: initial results and long-term follow-up in 379 consecutive patients. Eur Heart J 2001; 22: 82-8.