Randomized comparison of anatomic and electrogram mapping approaches to ablation of the slow pathway of atrioventricular node reentrant tachycardia

Kalbfleisch, Steven J.; Strickberger, S. Adam; Williamson, Brian D.; Vorperian, Vicken R.; Man, Ching; Hummel, John D.; Langberg, Jonathan J.; Morady, Fred

doi:10.1016/0735-1097(94)90759-5

Cited by 156 publications

(68 citation statements)

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“…8) Hwang, et al have reported successful radiofrequency ablation of the slow pathway in the posterior region of the right atrial septum, 8) as in the present case. 11,12) Furthermore, the slowest of the triple AV nodal pathways and the eccentric retrograde left-sided atrial activation recorded during ventricular pacing disappeared after slow pathway ablation. These results suggest that the eccentric retrograde left-sided pathway forms a part of the slow pathway.…”

Section: Discussionmentioning

confidence: 99%

“…A steerable 7 Fr ablation catheter with a 4-mm tip electrode (BLAZER-T, model 2531T, EP Technologies, Sunnyvale, CA) was inserted through the right femoral vein to a site near the coronary sinus ostium. Two radiofrequency current deliveries (15 to 25 W, 30 to 40 sec), which were usually used to slow pathway ablation, 10,11) were performed anatomically at the posterior aspect of the tricuspid septal annulus between the coronary sinus ostium and the His bundle recording site (Figure 4). After the selective slow pathway ablation, electrophysiologic study was performed again without isoproterenol infusion.…”

Section: Avnrt With Eccentric Retrograde Activationmentioning

confidence: 99%

See 1 more Smart Citation

Patient with Atrioventricular Node Reentrant Tachycardia with Eccentric Retrograde Left-sided Activation. Treatment with Radiofrequency Catheter Ablation.

et al. 2000

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Section: Discussionmentioning

confidence: 99%

Section: Avnrt With Eccentric Retrograde Activationmentioning

confidence: 99%

Patient with Atrioventricular Node Reentrant Tachycardia with Eccentric Retrograde Left-sided Activation. Treatment with Radiofrequency Catheter Ablation.

et al. 2000

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“…The incidence of this complication is considered low, with less than 1% in published studies 1,5,[16][17][18] . For that reason, in order to prevent complications such as TAVB during the ablation procedure, it is extremely important to observe the integrity of ventriculoatrial (V-A) conduction or the lengthening of the P-R interval 8,10,19,20 during JET.…”

Section: Discussionmentioning

confidence: 99%

Contribuição da análise eletrofisiológica e anatômica do circuito atípico da taquicardia atrioventricular nodal

Silva¹,

Sá²,

Fagundes³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjective: To analyze retrograde conduction during junctional ectopic tachycardia (JET) episodes and investigate the existence of a relationship between the presence of a retrograde block and the risk of atrioventricular block (AVB) development during radiofrequency ablation procedures in patients with nodal atrioventricular tachycardia (NAVT).Methods: 145 male and female patients aged 16-84 years, with NAVT who had undergone radiofrequency catheter ablation in the posteroseptal region of the right atrium were studied. Evaluation criteria were anatomical location and electrophysiological behavior of retrograde conduction during NAVT, in order to understand the nodal reentrant circuit (classifying the tachycardia as typical or atypical), and monitoring of retrograde conduction during JET episodes for riskpredicting AVB events.Results: Of the 145 patients studied, 132 (91%) met electrophysiological and anatomical criteria of the typical form of NAVT, and 13 (9%) of atypical form. During the ablation, 5.3% with the typical form and 30.8% of the atypical form presented risk events for AVB. After the ablation, complications were a total AVB episode in one patient and a firstdegree AVB episode in another in the typical group, and one first-degree AVB in the atypical group. All three episodes were preceded by risk events and resulted in permanent nodal injury. Conclusion:Patients with atypical NAVT presented higher percentages of risk events for atrioventricular block than did patients with the typical form (p=0.021).A careful observation of retrograde conduction during JET episodes is vital in order to avoid permanent damage in AV nodal conduction, such as TAVB, after the ablation procedure.

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“…The occurrence of junctional ectopy during perinodal RF energy delivery has been associated with the successful elimination of AVNRT (2). However, the electrophysiological features of different patterns of junctional rhythm (JR) and the importance of the multicomponent atrial electrogram are still unclear.…”

Section: Introductionmentioning

confidence: 99%

Which parameters describe the electrophysiological properties of successful slow pathway RF ablation in patients with common atrioventricular nodal reentrant tachycardia?

Nigro¹,

Russo²,

Rago³

et al. 2010

Anadolu Kardiyol Derg

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Which parameters describe the electrophysiological properties of successful slow pathway RF ablation in patients with common atrioventricular nodal reentrant tachycardia?Hangi parametreler ortak antriyoventriküler nodal reenrant taşikardisi olan hastalarda başarılı yavaş yol RF ablasyon seyrinin elektrofizyolojik özelliklerini tanımlar? 126ÖZET Amaç: Antriyoventriküler nodal reenrant taşikardi (AVNRT) paroksizmal supraventriküler taşikardili hastaların yaklaşık %60'ında görülür. Antriyoventriküler (AV) reenrant taşikardili hastalarda AV düğümün yavaş-yol radyofrekans (RF) kateter ablasyonu tercih edilen terapötik bir yaklaşımdır. Bu çalışmanın amacı, ortak AV nodal reenrant taşikardisi olan hastalarda başarılı yavaş-yol RF ablasyonun elektrofizyolojik özellik-lerini tanımlamaktı.Yöntemler: Bu çalışmanın dizaynı, AVNRT dolayısı ile yavaş-yol ablasyonu yapılan 50 ardışık hastayı içeren (18 erkek; ortalama 39±22 yaş) retrospektif bir analiz olarak tasarlanmıştır. Bulgular: Hastaların 39'unda (%79) 550 ms'den daha fazla siklus uzunluğu olan yavaş kavşak atımları gözlendi; siklus uzunluğu 550 ms'den daha az olan hızlı kavşak atımların varlığı 5 hastada (%10) görüldü. Bulguların analizinde, başarılı RF ablasyon işlemlerinde yavaş kavşak atımlarının varlığı (p<0.001) ve atriyal elektrogramın >40 ms olması istatistik açıdan önemli bulundu. Sonuç: Yavaş-yol ablasyonu yapılan AVRNT'li hastalarda RF enerji uygulama sırasında atriyal elektrogram süresinin >40 ms ve siklus uzunluğu >50 ms olan yavaş kavşak atımları başarılı yavaş-yol RF ablasyonunun elektrofizyolojik özellikleri olarak tanımlandı. ABSTRACTObjective: Atrioventricular nodal reentrant tachycardia (AVNRT) accounts for about 60% of the patients presenting with paroxysmal supraventricular tachycardia. The radiofrequency (RF) catheter ablation of the slow atrioventricular (AV) node pathway is the preferred therapeutic approach in patients with AV node reentrant tachycardia. The aim of our study was describe the electrophysiological properties of successful slow pathway RF ablation in patients with common atrioventricular nodal reentrant tachycardia. Methods: The study design was a retrospective analysis involving fifty consecutive patients (18 males; mean age of 39±22 years) who underwent slow pathway ablation because of AVNRT.Results: Slow junctional beats with a cycle length longer than 550 ms were observed in 39 patients (79%); the presence of rapid junctional beats with a cycle length less than 550 ms was showed in 5 patients (10%). Moreover, in 32 of 50 patients (65%) duration of atrial electrogram more than 40 ms was noticed. Analyzing data reported, we found the statistically significant presence of slow junctional beats (p<0.001) and atrial electrogram >40 ms (p<0.05) in successful RF ablation procedures. Conclusion:In patients with AVNRT undergoing slow pathway ablation, the duration of atrial electrogram >40 ms and slow junctional beats with cycle length >550 ms during the application of RF energy describe the electrophysiological properties of successfu...

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Randomized comparison of anatomic and electrogram mapping approaches to ablation of the slow pathway of atrioventricular node reentrant tachycardia

Cited by 156 publications

References 8 publications

Patient with Atrioventricular Node Reentrant Tachycardia with Eccentric Retrograde Left-sided Activation. Treatment with Radiofrequency Catheter Ablation.

Patient with Atrioventricular Node Reentrant Tachycardia with Eccentric Retrograde Left-sided Activation. Treatment with Radiofrequency Catheter Ablation.

Contribuição da análise eletrofisiológica e anatômica do circuito atípico da taquicardia atrioventricular nodal

Which parameters describe the electrophysiological properties of successful slow pathway RF ablation in patients with common atrioventricular nodal reentrant tachycardia?

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