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AV Nodal Reentrant Tachycardia
What is AV nodal reentrant tachycardia?
Tachycardia is the medical term for an abnormally fast heart rate. Sinus tachycardia is the term used to describe a resting heart rate of more than 100 beats per minute. Some tachycardias are considerably faster than this. In patients with AV nodal reentrant tachycardia (AVNRT) the heart rate is generally 160 to 220 beats per minute. This form of tachycardia is a "short circuit" in the electrical system of the heart.
What is the mechanism of AVNRT?
A normal heart beat starts in a collection of cells (the sinus node) in the right atrium. This electrical discharge leads to the contraction of the upper heart chambers. The electricity is then delayed for about 0.16 seconds in a structure called the AV node. The electricity is then rapidly conducted to the lower pumping chambers of the heart (the ventricles). In some people there can develop a short circuit within the AV node leading to a rapid circular electrical pathway within the AV node. This causes the lower chambers to beat at a rate of between 160 and 220 beats per minute.
Who gets AVNRT and how is it diagnosed?
AVNRT is most common in people in their 20's and 30's but can occur at any age. It is more common in women than in men. Because AVNRT causes a rapid heart rate, most patients feel their heart beating rapidly. This can feel like "my heart is jumping out of my chest". Many patients will also feel a sensation of chest pressure or shortness of breath. Depending upon its effect on blood pressure, some patients may feel light headed or may even faint.
The diagnosis is made by an electrocardiogram taken during an episode. Because this is an intermittent phenomenon, it may be difficult to record an episode. A Holter monitor is a 24 hour ECG tape recorder. This can be a helpful way to record an episode. Longer periods of monitoring may be necessary. A cardiac event recorder is a long term recording device. Specialized electrical studies of the heart (electrophysiological studies) can precisely define AVNRT especially if ablation therapy is planned. This is a hospital based study of your heart's electrical system.
How is AVNRT treated?
The key to stopping the tachycardia is interrupting the rapid electrical impulse within the AV node. There are nerve fibers that affect the electrical properties of the AV node. These can be stimulated by a variety of maneuvers including rubbing the neck artery (carotid artery) at the angle of the jaw, or by taking a breath and bearing down like you were having a bowel movement. The maneuvers may quickly abort the tachycardia. If the tachycardia is more persistent, there are drugs that can be tried. You can discuss this with your physician. Patients with frequent or prolonged episodes may be candidates for ablation therapy. This is a procedure that interrupts the short circuit pathway. A small tube or catheter is passed into the heart through a vein in the leg. The catheter is directed to the area of the AV node causing the tachycardia and radio frequency waves cause a small burn in the area interrupting the circuit. Successfully done, this cures the problem.
What is the mechanism of AVNRT?
A normal heart beat starts in a collection of cells (the sinus node) in the right atrium. This electrical discharge leads to the contraction of the upper heart chambers. The electricity is then delayed for about 0.16 seconds in a structure called the AV node. The electricity is then rapidly conducted to the lower pumping chambers of the heart (the ventricles). In some people there can develop a short circuit within the AV node leading to a rapid circular electrical pathway within the AV node. This causes the lower chambers to beat at a rate of between 160 and 220 beats per minute.
Who gets AVNRT and how is it diagnosed?
AVNRT is most common in people in their 20's and 30's but can occur at any age. It is more common in women than in men. Because AVNRT causes a rapid heart rate, most patients feel their heart beating rapidly. This can feel like "my heart is jumping out of my chest". Many patients will also feel a sensation of chest pressure or shortness of breath. Depending upon its effect on blood pressure, some patients may feel light headed or may even faint.
The diagnosis is made by an electrocardiogram taken during an episode. Because this is an intermittent phenomenon, it may be difficult to record an episode. A Holter monitor is a 24 hour ECG tape recorder. This can be a helpful way to record an episode. Longer periods of monitoring may be necessary. A cardiac event recorder is a long term recording device. Specialized electrical studies of the heart (electrophysiological studies) can precisely define AVNRT especially if ablation therapy is planned. This is a hospital based study of your heart's electrical system.
How is AVNRT treated?
The key to stopping the tachycardia is interrupting the rapid electrical impulse within the AV node. There are nerve fibers that affect the electrical properties of the AV node. These can be stimulated by a variety of maneuvers including rubbing the neck artery (carotid artery) at the angle of the jaw, or by taking a breath and bearing down like you were having a bowel movement. The maneuvers may quickly abort the tachycardia. If the tachycardia is more persistent, there are drugs that can be tried. You can discuss this with your physician. Patients with frequent or prolonged episodes may be candidates for ablation therapy. This is a procedure that interrupts the short circuit pathway. A small tube or catheter is passed into the heart through a vein in the leg. The catheter is directed to the area of the AV node causing the tachycardia and radio frequency waves cause a small burn in the area interrupting the circuit. Successfully done, this cures the problem.
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