Modification of Antegrade Slow Pathway is not Crucial for Successful Catheter Ablation of Common Atrioventricular Nodal Reentrant Tachycardia (original) (raw)

1999, Pacing and Clinical Electrophysiology

Ablation of Common Atrioventricular Nodal Reentrant Tachycardia./w^e tested the hypothesis that in some patients affected by typical AVNRT, successful catheter ablation treatment may be achieved independently of specific measurable electrophysiological modifications of antegrade AV node conducting properties. Standard electrophysiological parameters and comparable antegrade AV node function curves were obtained, before and after successful ablation, in 104 patients (mean age 52 ± 16 years; 69 women and 35 men) affected by the common form of AVNRT. The end point ofthe ablation procedure was noninducibility of AVNRT and of no more than one echo beat. For the purpose of this study, AVnode duality was defined as an increase of ^ 50 ms in the A2H2 interval in response to a 10 ms decrease ofthe A1A2 coupling interval. Refore ablation, AV node duality was present in 65 patients (62%) and absent in 39 patients (37%). Ablation caused measurable modifications of electrophysiological properties oftheAV node in most patients with elicited AV node duality, but not in most patients without demonstrable AV node duality. After ablation, AV node duality persisted in 20 patients who had it before, whereas a new duality that could not be elicited before appeared in 5 patients. During 19 ± 6 months of follow-up, clinical AVNRT recurred in 1 of 45 patients who had disappearance of AVnode duality after ablation, in 1 of 34 patients who did not show AV node duality before and after ablation, and in 1 of 20 patients who had persistence of AVnode duality after ablation. In conclusion, modifications of antegrade conduction properties of the AVnode are not crucial for the cure of AVNRT in many patients/ (PACE 1999; 22:263-267) AV nodal reentrant tachycardia, slow pathways, catheter ablation, electrophysiological study

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