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  • adenosine receptor agonist In the present study the TACT mea

    2019-04-22

    In the present study, the TACT measurement scores by EPS and TDI among women aged 20–30 were statistically and borderline significantly lower than in those aged 30–40. Similarly, men aged 20–30 years had lower scores than those aged 30–40. However, non-significant statistical differences were observed between the two groups. We believe that this is because of the small sample size. Similarly, the present study results clearly show decreased atrial conduction due to aging [11–14]. Kistler et al. showed that aging is associated with a decrease in the regional conduction, anatomically determined conduction delay at the crista, and structural changes that include areas of low voltage [11]. In an animal study, Hayashi et al. concluded that heterogeneous atrial interstitial fibrosis and atrial cell hypertrophy might contribute to decreased atrial conduction due to aging [12]. The incidence adenosine receptor agonist of atrial fibrillation (AF) increases with age. Anyukhovsky et al. concluded that dispersion of atrial repolarization increases with aging, creating a substrate for initiation of AF [13]. Additionally, Babaev et al. confirmed that age-related atrial conduction delay is also present in healthy subjects [14]. To the best of our knowledge, the present study is the first that has shown decreased atrial conduction due to aging by EPS and TDI in the literature.
    Conclusion
    Conflict of interest
    Introduction Entrainment pacing is useful not only in establishing reentry as a mechanism of tachycardia but also in identifying the pacing site relative to the slow conduction zone [1–3]. When manifest entrainment represented by constant fusion except for the last entrained beat in the electrocardiogram (ECG) is demonstrated, the pacing site is proximal to the slow conduction zone. When entrainment showing concealed fusion in the ECG, postpacing interval equal to the tachycardia adenosine receptor agonist length and stimulus-to-QRS (P) equal to electrogram-to-QRS (P), is demonstrated, the pacing site is on the critical slow conduction zone [4–6]. This “concealed entrainment” is widely used as a tool to identify the effective ablation site in reentrant tachycardias. Adenosine- or adenosine triphosphate (ATP)-sensitive atrial tachycardia (AT) (ATP-AT) with the earliest activation site (EAS) in the atrioventricular (AV) node vicinity was reported to be due to reentry [7], and catheter ablation performed for this specific AT has targeted the EAS with some risk of AV conduction impairment. ATP-AT was shown to have its origin not only in the vicinity of the AV node but also in other sites, including the coronary sinus ostium [8,9], tricuspid annulus [10,11], mitral annulus [12], and others [13]. By applying a single extrastimulus during ATP-AT originating from the AV node vicinity, Yamabe et al. demonstrated that verapamil- or ATP-sensitive atrial tissue not in the AV conduction system but close to the AV node forms the tachycardia reentry circuit [9]. More recently, while localizing the pacing site relative to the EAS during ATP-AT by using a noncontact mapping system (EnSite), Yamabe et al. demonstrated that this AT could be entrained by rapid pacing at a site remote from the EAS, fulfilling the classic or manifest entrainment criteria, and successfully ablated at the site that is supposed to be the entrance to the slow conduction zone [14]. This entrainment-based approach is rather different from those used previously [7–13], and therefore needs to be further validated. In the present study, we aimed to prospectively validate the efficacy of the combined use of a contact electroanatomical mapping system (CARTO) that is more accurate than the EnSite noncontact mapping system, and manifest entrainment in ablating this ATP-AT. We also sought whether any abnormal low-amplitude and fractionated electrograms, suggestive of slow conduction allowing small circuit reentry [15,16], were present particularly at the successful ablation site.
    Material and methods