Why the study?
Does selective fast or slow pathway ablation using radiofrequency energy improve freedom from AVNRT while maintaining intact AV conduction in patients with symptomatic AVNRT?
Does selective fast or slow pathway ablation using radiofrequency energy improve freedom from AVNRT while maintaining intact AV conduction in patients with symptomatic AVNRT?
Slow pathway ablation is highly effective and safer than fast pathway ablation for treating symptomatic AVNRT, minimizing the risk of complete AV block.
Supports preferring slow pathway ablation in AVNRT to minimize AV block risk; leaves open randomized confirmation of long-term outcomes.
One hundred twenty consecutive patients with symptomatic atrioventricular nodal reentrant tachycardia (AVNRT) underwent catheter ablation using radiofrequency energy. Fast pathway ablation was attempted in the first 16 consecutive patients by application of radiofrequency current in the anterior and superior aspect of the tricuspid annulus. Successful results were accomplished in 13 patients, complete atrioventricular (AV) block occurred in three. One hundred four patients underwent ablation of the slow pathway in the posterior and inferior aspect of the tricuspid annulus, which was successful in 98 patients. The remaining six patients subsequently underwent a fast pathway ablation with successful results in four and AV block in two. Therefore, 102 (98%) of the last 104 patients became free of AVNRT while maintaining intact AV conduction. This study characterizes the electrophysiological properties of the residual AV node following a selective fast or slow pathway ablation.
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Jazayeri et al. (1993) studied this question.
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