Why the study?
Does operative dissection of the AV junction prevent paroxysmal supraventricular tachycardia in a patient with drug-refractory AV node reentry?
Does operative dissection of the AV junction prevent paroxysmal supraventricular tachycardia in a patient with drug-refractory AV node reentry?
Operative dissection of the AV junction can successfully abolish drug-refractory paroxysmal supraventricular tachycardia while preserving AV conduction.
Single case suggests AV junction dissection may control refractory PSVT with preserved conduction; hypothesis-generating and should not yet change practice.
Paroxysmal supraventricular tachycardia (PSVT) is commonly caused by reentry within the atrioventricular (AV) node. This arrhythmia was abolished by operative dissection of the AV junction in a patient with disabling tachycardia that was not controlled by drugs. The operation was intended to create complete AV block, but AV conduction persisted after surgery. An electrophysiologic study 1 year after the operation revealed that the operation changed AV conduction in both the antegrade and retrograde directions, which may explain the absence of tachycardia. The patient has been free of arrhythmias for 18 months.
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Pritchett et al. (1979) studied this question.