Identification of the critical isthmus in reentrant AVN-AT using PPI–TCL-guided manifest entrainment and pre-systolic potential mapping

HeartRhythm Case Reports 2026 Open access

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Authors: Masahiro Kawasaki, Taro Temma, Ryo Sasaki, Ryudai Hirako, Taro Koya, Toshihisa Anzai
DOI: 10.1016/j.hrcr.2026.02.018
Cited by: 0
References: 5

Abstract

Adenosine-sensitive atrial tachycardia originating from the vicinity of the atrioventricular node (AVN-AT) is characterized by a reentrant mechanism involving a slow conduction zone (SCZ) composed of calcium channel–dependent tissues.1 Yamabe et al. have proposed a method to identify the earliest atrial activation site (EAAS) during tachycardia as the exit of the reentrant circuit, and to estimate the SCZ entrance using the manifest entrainment technique.2 Ablation targeting the presumed SCZ entrance identified by this method has been reported to achieve greater efficacy and safety than EAAS-guided ablation.

Fields of Study & Subjects

Cardiac Arrhythmias and Treatments Cardiac electrophysiology and arrhythmias Cardiac pacing and defibrillation studies

Publication details

Journal / source
HeartRhythm Case Reports
Volume
12
Issue
6
Pages
667–670
Publication date
27 February 2026
Language
EN