Should fast pathway ablation be reconsidered in typical atrioventricular nodal re‐entrant tachycardia?
| العنوان: | Should fast pathway ablation be reconsidered in typical atrioventricular nodal re‐entrant tachycardia? |
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| المؤلفون: | Patrick J. Tchou, Newton B. Wiggins, Niraj Varma, Walid Saliba, Stephen Tuohy, Eric L Kiehl, Kevin Trulock, Daniel J. Cantillon, Thomas Dresing, Christine Tanaka, Khaldoun G. Tarakji, Maki Ono, Mohammed Bassiouny |
| المصدر: | Journal of Cardiovascular Electrophysiology. 30:1569-1577 |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, Tachycardia, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Action Potentials, Catheter ablation, 030204 cardiovascular system & hematology, Electrocardiography, 03 medical and health sciences, Electrophysiology study, 0302 clinical medicine, Heart Rate, Recurrence, Risk Factors, Physiology (medical), Internal medicine, medicine, Humans, Tachycardia, Atrioventricular Nodal Reentry, Sinus rhythm, 030212 general & internal medicine, PR interval, Atrioventricular Block, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Middle Aged, Ablation, medicine.disease, Treatment Outcome, Atrioventricular Node, Catheter Ablation, Cardiology, Female, Supraventricular tachycardia, medicine.symptom, Electrophysiologic Techniques, Cardiac, Cardiology and Cardiovascular Medicine, business, Atrioventricular block |
| الوصف: | Introduction Atrioventricular nodal re-entry tachycardia (AVNRT) is the most common, regular narrow-complex tachycardia. The established treatment is catheter ablation of the AV nodal slow pathway (SP). However, in a select group of patients with long PR intervals in sinus rhythm, SP ablation can lead to AV block due to the absence of robust anterograde conduction through the fast pathway (FP). This report aims to demonstrate that AV nodal FP ablation is a reasonable approach in patients with AVNRT and poor or absent anterograde FP conduction. Methods and results Standard electrophysiology study techniques were used in the electrophysiology laboratory. Catheter ablations were performed using radiofrequency energy. Mapping of intracardiac activation was performed with electroanatomical mapping systems. Outcomes were assessed acutely during the procedure and during routine clinical follow-up. Six patients with first-degree AV block and recurrent AVNRT who underwent ablation of their tachycardia at our institution are presented. One patient underwent ablation of AV nodal SP resulting in high-degree AV block necessitating pacemaker implantation. The remaining five patients underwent ablation of the AV nodal FP guided by electroanatomical mapping of the earliest atrial activation in tachycardia. These five had successful treatment of the tachycardia with preservation of anterograde AV nodal conduction. Mapping and ablation approach to eliminate retrograde FP conduction are described. Conclusion In select patients with AVNRT and poor anterograde FP conduction, retrograde FP ablation is reasonable and is less likely to result in AV block and pacemaker dependency. |
| تدمد: | 1540-8167 1045-3873 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5866387a1f8b78036ca1c756abf1e635 https://doi.org/10.1111/jce.14012 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....5866387a1f8b78036ca1c756abf1e635 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15408167 10453873 |
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