Pace Mapping of Koch's Triangle Reduces Risk of Atrioventricular Block During Ablation of Atrioventricular Nodal Reentrant Tachycardia

Delise, Pietro; Sitta, Nadir; Bonso, Aldo; Corò, Leonardo; Fantinel, Mauro; Mantovan, Roberto; Sciarra, Luigi; Zoppo, Franco; Verlato, Roberto; Marras, Elena; D’Este, D

doi:10.1046/j.1540-8167.2005.04054.x

Cited by 26 publications

(24 citation statements)

References 8 publications

(26 reference statements)

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“…Incidence of AV block following AVNRT RFCA has been reported to occur in a percentage of patients of about 0.5-2% [7,22,23], and a large meta-analysis reporting an incidence of 1.7% [10].…”

Section: Discussionmentioning

confidence: 99%

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Matta

Anselmino

Scaglione

et al. 2016

J Interv Card Electrophysiol

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Purpose. Catheter ablation of the slow pathway is the most effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). Cryoenergy, compared to radiofrequency, relates to lower heart block risk, but higher incidence of AVNRT recurrences. The aim of this study is to confirm safety and efficacy of AVNRT cryoablation and to identify predictors of long-term recurrences. Conclusions. AVNRT cryoablation is safe and effective. Long-term recurrence rate was 11.7%. An ablation approach directed to the complete elimination of dual AV node physiology, along with assessment of tissue's cooling dynamics, hold the potential to improve long-term AVNRT cryoablation efficacy. Methods andAbstract word count: 244 2

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“…Incidence of AV block following AVNRT RFCA has been reported to occur in a percentage of patients of about 0.5-2% [7,22,23], and a large meta-analysis reporting an incidence of 1.7% [10].…”

Section: Discussionmentioning

confidence: 99%

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Matta

Anselmino

Scaglione

et al. 2016

J Interv Card Electrophysiol

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“…Acute and long term success with respect to the primary electrophysiological outcome has been very well documented 6, 9, 10, 20, 24.…”

Section: Discussionmentioning

confidence: 99%

Sustained High Quality of Life in a 5-Year Long Term Follow-up after Successful Ablation for Supra-Ventricular Tachycardia. Results from a large Retrospective Patient Cohort

Meißner¹,

Stifoudi²,

Weismüller³

et al. 2009

Int. J. Med. Sci.

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Introduction: The ablation of supraventricular tachycardias (SVT) using radiofrequency energy (RF) is a procedure with a high primary success rate. However, there is a scarcity of data regarding the long term outcome, particularly with respect to quality of life (QoL).Methods and Results: In this retrospective single-center study, 454 patients who underwent ablation of SVT between 2002 and 2007 received a detailed questionnaire addressing matters of QoL. The questionnaire was a modified version of the SF-36 Health Survey questionnaire and the Symptom Checklist – Frequency and Severity Scale.After a mean follow up of 4.5±1.3 years, 309 (68.1%) of the contacted 454 patients (269 female, 59.2%, mean age 58+/-6.5) completed the questionnaire. Despite of 27% of relapses in the study group, 91.7% considered the procedure a long-term success. The remainder of patients experienced no change in (3.7%) or worsening of (4.7%) symptoms. There were no significant differences between the various types of SVT (p=1). QoL in patients with Atrio-Ventricular Nodal Reentry Tachycardia (AVNRT) and Atrio-Ventricular Reentry Tachycardia (AVRT) improved significantly (p<0.0005 respectively p<0.043), whereas QoL in patients with Ectopic Atrial Tachycardia (EAT) showed a non-significant trend towards improvement. Main symptoms before ablation, such as tachycardia (91.5%), increased incidence of tachycardia episodes over time (78.1%), anxiety (55.5%) and reduced physical capacity in daily life (52%) were significantly improved after ablation (p<0.0001).Conclusion: The high acute ablation success of SVT persists for years in long term follow up and translates into a significant improvement of QoL in most patients.

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“…Ablation was associated with a significant increase in PR interval, transient high grade AV block in all patients and persistent AV block in two patients. Delise et al [28] studied a large group undergoing ablation of AVNRT. They compared conventional slow pathway ablation with slow pathway ablation guided by pace mapping of Koch's triangle to identify the location of the fast pathway.…”

Section: Risk Of Av Blockmentioning

confidence: 99%

New Insights into Reentry Circuits from Mapping and Ablation of Atrioventricular Nodal Reentrant Tachycardia

Walters

Kalman

2012

Cardiac Mapping

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Atrioventricular nodal reentrant tachycardia (AVNRT) is a very common cardiac arrhythmia and is due to reentry within the region of the atrioventricular junction. The anatomy of the atrioventricular (AV) node, including inferior extensions within the triangle of Koch and a transitional zone of cells interposed between the compact node and atrial myocardial cells, has been extensively investigated. The functional inputs to the AV node have been revealed to be multiple, from both sides of the interatrial septum. Despite this knowledge the precise nature of the reentry circuit and its variants remains elusive, with a variety of proposed models. Regardless, catheter ablation of the slowly conducting pathway inferior to the compact node, within the triangle of Koch or anterior to the ostium of the coronary sinus, is a highly effective method by which the circuit can be disrupted and AVNRT eliminated.

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Pace Mapping of Koch's Triangle Reduces Risk of Atrioventricular Block During Ablation of Atrioventricular Nodal Reentrant Tachycardia

Abstract: Pace mapping of Koch's triangle identifies patients in whom the AFP is absent or is abnormally close to the slow pathway. In these cases, guiding ablation helps to avoid AV block.

Cited by 26 publications

References 8 publications

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Sustained High Quality of Life in a 5-Year Long Term Follow-up after Successful Ablation for Supra-Ventricular Tachycardia. Results from a large Retrospective Patient Cohort

New Insights into Reentry Circuits from Mapping and Ablation of Atrioventricular Nodal Reentrant Tachycardia

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