Why the study?
Does radiofrequency ablation near the ostium of the coronary sinus prevent recurrence in a patient with AV nodal tachycardia showing changing RR intervals and QRS morphologies?
Does radiofrequency ablation near the ostium of the coronary sinus prevent recurrence in a patient with AV nodal tachycardia showing changing RR intervals and QRS morphologies?
This case report suggests that changing RR intervals and QRS morphologies in AV nodal tachycardia may reflect extranodal involvement, which can be successfully treated with radiofrequency ablation.
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May indicate extranodal involvement in atypical AVNRT amenable to targeted ablation; hypothesis-generating and requires prospective confirmation.
A young patient with AV nodal tachycardia was referred for ablation. During electrophysiological testing, a stable succession of up to four different RR intervals with concomitantly changing QRS morphologies were recorded. This observation might reflect the conduction of the reentry circuit through different extranodal "pathways" in the low right atrium. Radiofrequency current was applied near the ostium of the coronary sinus; this abolished conduction through the slow pathway, as dual AV conduction was no longer present. She remains free of recurrences for a follow-up period of 8 months.
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Vertongen et al. (1993) studied this question.
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