Key result
Complete slow pathway ablation shortened the effective refractory period of the fast pathway using both cryoablation and RF ablation.
Why the study?
Does cryoablation compared to radiofrequency ablation of the slow pathway differently affect the effective refractory period of the fast pathway in patients with AVNRT?
Cohort (n=112)
Does cryoablation compared to radiofrequency ablation of the slow pathway differently affect the effective refractory period of the fast pathway in patients with AVNRT?
Shortening of the fast pathway effective refractory period after slow pathway ablation occurs with both cryoablation and RF ablation, suggesting electrotonic interaction rather than heat or autonomic changes as the underlying mechanism.
Answers are grounded in this paper and cite their sources.
Fast pathway ERP shortening occurs equally with cryoablation or RF; confirms electrotonic interaction rather than thermal effects.
BACKGROUND: In typical atrioventricular nodal reentrant tachycardia, radiofrequency (RF) ablation of the slow pathway (SP) is known to change the effective refractory period of the fast pathway (ERP(FP)) after successful RF ablation of the SP. The purpose of this study was to ascertain the mechanism of the ERP(FP) changes after SP ablation by comparing the results of both cryo- and RF ablation. METHODS AND RESULTS: A total of 112 patients were enrolled prospectively and their electrophysiological properties analyzed before and after successful SP ablation. Patients were grouped into cryoablation (n=54) and RF ablation (n=58) groups and each group was subdivided into complete ablation (CG) and modification (MG) based on the presence of the SP after successful ablation. CG was performed in 64 patients: 30 by cryoablation and 34 by RF ablation. In patients who underwent complete SP ablation, the ERP(FP) was shortened significantly after cryoablation (375 ± 74 vs. 281 ± 39 ms, P<0.01), without significant change in the atrio-His (AH) or sinus cycle length (SCL) interval. Similarly, the ERP(FP) was shortened significantly (358 ± 106 vs. 289 ± 84 ms, P=0.01) also after RF ablation without change in AH or SCL interval. CONCLUSIONS: ERP(FP) shortening was observed after complete SP ablation with both cryo- and RF ablation without significant changes in indices of autonomic activity.
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Park et al. (2012) conducted a cohort in Atrioventricular Nodal Reentrant Tachycardia (n=112). Slow pathway ablation (cryoablation or radiofrequency ablation) vs. Baseline (before ablation) was evaluated on Effective refractory period of the fast pathway (ERP(FP)) (p=<0.01). Complete slow pathway ablation shortened the effective refractory period of the fast pathway using both cryoablation and RF ablation.
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