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June 27, 2006Journal of Cardiovascular ElectrophysiologyOpen Access

Ablation for Atrioventricular Nodal Reentrant Tachycardia with a Prolonged PR Interval During Sinus Rhythm: The Risk of Delayed Higher‐Degree Atrioventricular Block

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Why the study?

Does retrograde fast pathway ablation prevent delayed higher-degree AV block compared to slow pathway ablation in patients with AV nodal reentrant tachycardia and a prolonged PR interval?

Population

43 patients with atrioventricular nodal reentrant tachycardia and a prolonged PR interval

Comparison

Retrograde fast pathway ablation vs Slow pathway ablation

Design

Cohort

Follow-up

61 ± 39 months and 37 ± 25 months

Authors

CRChristopher ReithmannTRT. RempNONICO OVERSOHL

Discussion

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Overview

Retrograde fast pathway ablation may avoid delayed AV block risk in AVNRT with prolonged PR; leaves open need for randomized confirmation.

Structured PICO

Does retrograde fast pathway ablation prevent delayed higher-degree AV block compared to slow pathway ablation in patients with AV nodal reentrant tachycardia and a prolonged PR interval?

P
Population
43 patients with atrioventricular (AV) nodal reentrant tachycardia and a prolonged PR interval (defined as ≥200 msec)
I
Intervention
Retrograde fast pathway ablation (performed in 10 patients without demonstrable dual pathway physiology)
C
Comparator
Slow pathway ablation (performed in 33 patients with dual pathway physiology)
O
Outcome
Development of delayed higher-degree atrioventricular block during long-term follow-upsafety

In patients with AV nodal reentrant tachycardia and a prolonged PR interval, slow pathway ablation is associated with a significant risk of delayed higher-degree AV block, whereas retrograde fast pathway ablation avoids this long-term risk despite a higher intraprocedural risk.

Cite This Study

Reithmann et al. (2006) studied this question.

synapsesocial.com/papers/6a7e659dda245de5ee4c42d3https://doi.org/10.1111/j.1540-8167.2006.00537.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Safety of Slow Pathway Ablation in Patients with Long PR Interval: Further Evidence of Fast and Slow Pathway Interaction1997 · 35 citations
  2. 2Fast pathway ablation in patients with common atrioventricular nodal reentrant tachycardia and prolonged PR interval during sinus rhythm1998 · 25 citations
  3. 3Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval2001 · 71 citations
  4. 4Long-term safety and efficacy of slow pathway ablation in patients with atrioventricular nodal re-entrant tachycardia and pre-existing prolonged PR interval2006 · 32 citations
  5. 5Physiology of “Atypical” Atrioventricular Junctional Reentrant Tachycardia Occurring Following Radiofrequency Catheter Modification of the Atrioventricular Node1992 · 47 citations