Key result
Retrograde AV nodal pathway ablation resolves refractory atypical PMT without further damaging AV conduction.
Why the study?
Atypical, long-RP pacemaker-mediated tachycardia caused by rate-adaptive AV delay algorithm shortening the antegrade SAV and retrograde conduction over the slow AV nodal pathway was refractory to usual programming solutions.
Case Report (n=1)
Ablation of the retrograde AV nodal pathway using high-density electroanatomic mapping can successfully treat atypical pacemaker-mediated tachycardia refractory to programming.
No takes yet. Share an insight, caveat, or question.
May support targeted ablation in refractory atypical PMT; hypothesis-generating and should not yet change practice.
Shelton et al. (2020) conducted a case report in Atypical pacemaker-mediated tachycardia (n=1). Ablation of the retrograde AV nodal pathway was evaluated on Resolution of pacemaker-mediated tachycardia without damaging AV conduction. Ablation of the retrograde limb of the AV nodal pathway successfully treated refractory atypical pacemaker-mediated tachycardia without further damaging AV conduction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: