Dual atrioventricular nodal non-re-entrant tachycardia

TY - JOUR

T1 - Dual atrioventricular nodal non-re-entrant tachycardia

AU - Peiker, Christiane

AU - Pott, Christian

AU - Eckardt, Lars

AU - Kelm, Malte

AU - Shin, Dong-In

AU - Willems, Stephan

AU - Meyer, Christian

N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

PY - 2016/3

Y1 - 2016/3

N2 - Dual atrioventricular nodal non-re-entrant tachycardia (DAVNNT), also known as 'double fire', has recently received more attention since it was demonstrated to mimic more common arrhythmias such as atrial premature beats, atrial fibrillation, and ventricular tachycardia. This is important, since mistaken differential diagnoses and the resulting therapeutic decisions have severe consequences for affected patients. DAVNNT is characterized by conduction characteristics of the atrioventricular (AV) node that leads to a double antegrade conduction of one sinoatrial nodal activity via the slow and fast AV nodal pathways. As a result, the most significant hint from an electrocardiogram (ECG) is a P wave followed by two narrow QRS complexes. Although DAVNNT is rather a rare arrhythmia, it now appears to be more common than previously thought. To date, 68 cases including 3 small single-centre observational studies accumulated over the last 5 years have demonstrated the feasibility and safety of radiofrequency catheter ablation for DAVNNT. Catheter ablation treats this arrhythmia effectively by modifying or eliminating slow pathway function. Here, we review the current state of DAVNNT knowledge systematically and address current challenges presented by this 'ECG chameleon from the AV node'.

AB - Dual atrioventricular nodal non-re-entrant tachycardia (DAVNNT), also known as 'double fire', has recently received more attention since it was demonstrated to mimic more common arrhythmias such as atrial premature beats, atrial fibrillation, and ventricular tachycardia. This is important, since mistaken differential diagnoses and the resulting therapeutic decisions have severe consequences for affected patients. DAVNNT is characterized by conduction characteristics of the atrioventricular (AV) node that leads to a double antegrade conduction of one sinoatrial nodal activity via the slow and fast AV nodal pathways. As a result, the most significant hint from an electrocardiogram (ECG) is a P wave followed by two narrow QRS complexes. Although DAVNNT is rather a rare arrhythmia, it now appears to be more common than previously thought. To date, 68 cases including 3 small single-centre observational studies accumulated over the last 5 years have demonstrated the feasibility and safety of radiofrequency catheter ablation for DAVNNT. Catheter ablation treats this arrhythmia effectively by modifying or eliminating slow pathway function. Here, we review the current state of DAVNNT knowledge systematically and address current challenges presented by this 'ECG chameleon from the AV node'.

KW - Action Potentials

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Arrhythmias, Cardiac/diagnosis

KW - Atrioventricular Node/physiopathology

KW - Catheter Ablation

KW - Diagnosis, Differential

KW - Electrocardiography

KW - Electrophysiologic Techniques, Cardiac

KW - Female

KW - Heart Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Tachycardia, Atrioventricular Nodal Reentry/diagnosis

KW - Young Adult

U2 - 10.1093/europace/euv056

DO - 10.1093/europace/euv056

M3 - SCORING: Review article

C2 - 25888570

VL - 18

SP - 332

EP - 339

JO - EUROPACE

JF - EUROPACE

SN - 1099-5129

IS - 3

ER -