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Fast pathway ablation in patients with common atrioventricular nodal reentrant tachycardia and prolonged PR interval

C Reithmann1, E Hoffmann, A Grünewald

  • 1Medizinische Klinik I, Klinikum Grosshadern, Universität München, Germany.

European Heart Journal
|July 4, 1998
PubMed

Insights

Selective fast pathway ablation is safe and effective for atrioventricular nodal reentrant tachycardia (AVNRT) patients with prolonged PR intervals. This procedure successfully terminated AVNRT without causing significant atrioventricular block during follow-up.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Atrioventricular nodal reentrant tachycardia (AVNRT) is a common supraventricular tachycardia.
  • Patients with AVNRT and a prolonged PR interval during sinus rhythm may have an increased risk of complete atrioventricular block.
  • Selective fast pathway ablation offers a potential treatment strategy for these patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of selective fast pathway ablation in patients with AVNRT and a prolonged PR interval.
  • To assess the risk of atrioventricular block during and after the ablation procedure.

Main Methods:

  • Localization of earliest retrograde atrial activation during AVNRT and right ventricular stimulation.
  • Radiofrequency catheter ablation of the fast pathway in five patients.
  • Assessment of ventriculo-atrial block and non-inducibility of AVNRT.
  • Monitoring of PR and atrio-His intervals.
  • Follow-up for symptoms and atrioventricular block.

Main Results:

  • Successful ablation achieved complete ventriculo-atrial block in four patients and marked prolongation in one.
  • Non-inducibility of AVNRT was achieved in all patients.
  • No second- or third-degree atrioventricular block occurred during the procedure.
  • PR and atrio-His intervals showed significant prolongation post-ablation.
  • No AVNRT recurrence or AV block was observed during a mean follow-up of 19 months.

Conclusions:

  • Selective fast pathway ablation appears to be a safe and effective treatment for AVNRT in patients with a prolonged PR interval.
  • The procedure does not significantly increase the risk of atrioventricular block in this patient population.
Abstract

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