A randomized, prospective comparison of anterior and posterior approaches to radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia (original) (raw)

BACKGROUND Two different techniques have been developed for radiofrequency catheter ablation of typical atrioventricular nodal reentry (AVNRT). Lesions made anteriorly near the apex of the triangle of Koch usually eliminate fast pathway function, whereas lesions made posteriorly near the ostium of the coronary sinus selectively affect slow pathway function. The current study compares the safety, efficacy, and electrophysiological effects of these two techniques in a prospective, randomized fashion. METHODS AND RESULTS Fifty consecutive patients with typical AVNRT were randomly assigned to receive radiofrequency lesions either anteriorly (n = 22) or posteriorly (n = 28). If the initial approach failed to eliminate inducibility of AVNRT after 1 hour or 10 applications of radiofrequency energy, the alternative ablation technique was used. Patients underwent repeat electrophysiological testing 48 hours and 3 months after ablation. The primary success rates of the anterior and posterior ...