Structural Characteristics of Koch's Triangle in Patients with Atrioventricular Node Reentrant Tachycardia

Hiraoka Akito

Karakawa Shinji

Yamagata Togo

Matsuura Hideo

Kajiyama Goro

Hiroshima Journal of Medical Sciences

[PISSN] 0018-2052

[EISSN] 2433-7668

[NCID] AA00664312

The aim of this study is to investigate whether patients with atrioventricular node reentrant tachycardia (AVNRT) present different structural characteristics of Koch's triangle from patients with atrioventricular (AV) reentrant tachycardia and other control patients. Fifty-eight patients with arrhythmia or chest pain underwent selective coronary sinus angiography so that the diameter of the coronary sinus could be measured. The patients with arrhythmia also underwent electrophysiological study and measurement of the height of Koch's triangle. Patients with AVNRT had large coronary sinus ostial diameters compared with patients with AV reentrant tachycardia and those with chest pain (13.6 ± 2.2 mm vs. 10.6 ± 2. 7 mm [p < 0.005] and 10.0 ± 2.1 mm [p < 0.002], respectively), while there were no differences in distal diameter. The ostial diameter in patients with dual AV node pathways but noninducible AVNRT (11.8 ± 1.5 mm) tended to be smaller than that in patients with AVNRT. No differences in the height of Koch's triangle and electrophysiological characteristics, including AV node properties, were found among the study groups. In conclusion, an increased size of the coronary sinus ostium (the base of Koch's triangle) is a structural characteristic in patients with AVNRT and may be the substrate needed for the appearance of AVNRT.

Atrioventricular node reentrant tachycardia

Coronary sinus ostium

Dual atrioventricular node pathways

Medical sciences [ 490 ]

eng

Hiroshima University Medical Press

[ISSN] 0018-2052

[NCID] AA00664312