Does attempted catheter ablation of the His bundle prevent recurrence of symptomatic arrhythmias in patients with refractory supraventricular tachyarrhythmias?
Unsuccessful His bundle ablation (failure to achieve permanent complete heart block) may still result in long-term symptomatic relief from refractory supraventricular arrhythmias without requiring permanent ventricular pacing.
Six patients underwent attempted catheter ablation of the His bundle for control of refractory supraventricular tachyarrhythmias. Permanent complete heart block was achieved in only three patients. All six patients have remained asymptomatic without antiarrhythmic medications over a follow-up period of six to 17 months (mean 10 months). There were no complications of the procedure apart from mild elevation of creatine kinase levels in three patients. In this series, resumption of atrioventricular (AV) conduction following attempted His bundle ablation was not associated with recurrence of symptomatic arrhythmias. Preservation of AV conduction may also obviate the need for permanent ventricular pacing.
Johns et al. (Tue,) studied this question.