Key result
Atrial flutter was inducible in a significantly greater percentage of patients with AVNRT compared to controls (53% vs 27%, p<0.02), and slow pathway ablation did not influence this inducibility.
Why the study?
Does the presence of AVNRT increase the inducibility of atrial flutter, and does slow pathway ablation eliminate this inducibility?
Observational (n=170)
Does the presence of AVNRT increase the inducibility of atrial flutter, and does slow pathway ablation eliminate this inducibility?
Patients with AVNRT have a significantly higher rate of inducible atrial flutter, but radiofrequency ablation of the slow pathway does not eliminate this inducibility, suggesting the critical areas for the two circuits may differ.
AVNRT patients show higher atrial flutter inducibility unaffected by slow pathway ablation; hypothesis-generating for distinct circuit mechanisms.
BACKGROUND: Previous studies have shown that both atrioventricular nodal reentrant tachycardia (AVNRT) and atrial flutter (AFL) have an area of slow conduction located in the low posterior right atrium near the ostium of the coronary sinus. The aim of this study was to evaluate the inducibility of AFL in patients with AVNRT. METHODS AND RESULTS: One hundred and seventy patients were prospectively evaluated for inducibility of tricuspid valve - inferior vena cava isthmus-dependent AFL. Two groups of patients were analyzed: 71 patients with inducible AVNRT and 99 control patients without a history of AFL. AFL was induced in a greater percentage of patients with AVNRT (53%) than of control patients (27%, p<0.02). In all 21 patients with AVNRT and inducible AFL before slow pathway ablation, AFL was also inducible after slow pathway ablation. There was no difference in the cycle length of induced AFL before and after ablation. CONCLUSIONS: AFL was induced in a greater percentage of patients with AVNRT, suggesting that there may be a common area of posteroseptal perinodal atrium participating in the two-tachycardia circuits. However, radiofrequency ablation of the slow pathway of the AVNRT circuit does not influence the inducibility of AFL.
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Takagi et al. (2006) conducted an observational in Atrioventricular Nodal Reentrant Tachycardia (AVNRT) (n=170). Presence of AVNRT vs. Control patients without a history of atrial flutter was evaluated on Inducibility of tricuspid valve - inferior vena cava isthmus-dependent atrial flutter (p=<0.02). Atrial flutter was inducible in a significantly greater percentage of patients with AVNRT compared to controls (53% vs 27%, p<0.02), and slow pathway ablation did not influence this inducibility.
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