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Atrioventricular nodal physiology after slow pathway ablation
A Takahashi1, Y Iesaka, M Igawa
1Cardiovascular Center, Tsuchiura Kyodo Hospital, Ibaraki-ken, Japan.
Pacing and Clinical Electrophysiology : PACE
|November 1, 1994
Summary
Radiofrequency ablation successfully treated AV nodal reentrant tachycardia in all patients. While fast pathway conduction remained unchanged, slow pathway conduction was eliminated in 31% and altered in the rest.
Area of Science:
- Electrophysiology
- Cardiology
Background:
- Atrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia.
- Catheter ablation targeting the slow pathway is a standard treatment for AVNRT.
Purpose of the Study:
- To evaluate the electrophysiological changes in AV nodal physiology after slow pathway potential-guided catheter ablation for AVNRT.
Main Methods:
- Thirty-two patients with AVNRT underwent catheter ablation guided by slow pathway potentials.
- Electrophysiological parameters, including sinus cycle length and pathway conduction properties, were assessed before and one week after ablation.
Main Results:
- Radiofrequency ablation eliminated AVNRT in all patients, with a mean of 4.9 applications.
- Slow pathway conduction was completely eliminated in 31% of patients; residual conduction with AV node echo was observed in the remainder.
- Significant prolongation of the slow pathway effective refractory period and A2-H2 interval was noted in 22% of patients post-ablation.
Conclusions:
- Slow pathway-guided catheter ablation is effective in eliminating AVNRT.
- Ablation can lead to complete elimination or significant modification of slow pathway conduction, impacting refractory periods.