Copyright © 1998 by the European Society of Cardiology.
Fast pathway ablation in patients with common atrioventricular nodal reentrant tachycardia and prolonged PR interval during sinus rhythm
Medizinische Klinik I, Klinikum Grosshadern, Universität München, Germany
accepted October 15, 1997
Aims
This study aimed to clarify the safety and efficacy of selective fast pathway ablation in patients with atrio-ventricular nodal reentrant tachycardia and a prolonged PR interval during sinus rhythm. Such patients have been reported to have an increased incidence of complete atrioventricular block.
Methods and Results
In this study, the earliest retrograde atrial activation during atrioventricular nodal reentrant tachycardia and right ventricular stimulation was localized. Fast pathway ablation was then performed in five patients with the common form of atrioventricular nodal reentrant tachycardia and a prolonged PR interval. Three of the five patients had almost incessant atrioventricular nodal re-entrant tachycardia. Radiofrequency catheter ablation induced a complete ventriculo-atrial block during right ventricular stimulation in four patients and a marked prolongation of ventriculo-atrial conduction during right ventricular stimulation in one. Non-inducibility of common atrioventricular nodal reentrant tachycardia with and without isoproterenol was achieved in all five patients. The PR interval increased from 254±53ms to 276±48ms and the atrio-His interval from 172±46ms to 192±45ms. Second- or third-degree atrioventricular block did not occur during the ablation procedure. During the follow-up of 19±20 months none of the patients developed symptoms suggestive of atrioventricular nodal reentrant tachycardia or evidence of second- or third-degree atrioventricular block.
Conclusion
These data suggest that atrioventricular node (retrograde) fast pathway ablation can apparently be safely performed in patients with common atrioventricular nodal reentrant tachycardia and a prolonged PR interval during sinus rhythm.
Key Words: atrioventricular nodal reentrant tachycardia • atrioventricular block • catheter ablation
f1 Correspondence: Dr C. Reithmann, Medizinische Klinik I, Klinikum Großhadern, Universität München, Marchioninistr. 15, D-81377 München, Germany.
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