Document Detail

Ablation for atrioventricular nodal reentrant tachycardia with a prolonged PR interval during sinus rhythm: the risk of delayed higher-degree atrioventricular block.
MedLine Citation:
PMID:  16800857     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Delayed higher-degree atrioventricular (AV) block can develop after slow pathway ablation for AV nodal reentrant tachycardia with a preexisting first-degree AV block. Retrograde fast pathway ablation is considered as an alternative approach for patients with a markedly prolonged PR interval and no demonstrable anterograde fast pathway function at baseline. This study aimed to determine the long-term reliability of AV conduction after retrograde fast pathway ablation in comparison to slow pathway ablation in patients with AV nodal reentrant tachycardia and a first-degree AV block at baseline. METHODS AND RESULTS: Among 43 patients with AV nodal reentrant tachycardia and a prolonged PR interval (defined as >or=200 msec), 10 patients without demonstrable dual pathway physiology underwent ablation of the retrograde fast pathway, and 33 patients with dual pathway physiology underwent slow pathway ablation. Persisting intraprocedural second- or third-degree AV block requiring pacemaker implantation occurred in one patient (10%) after retrograde fast pathway ablation and in one patient (3%) after slow pathway ablation. During the long-term follow-up of 61 +/- 39 months after retrograde fast pathway ablation, no delayed second- or third-degree AV block occurred, and the PR interval remained unchanged (308 +/- 60 msec vs 304 +/- 52 msec). During the follow-up of 37 +/- 25 months after slow pathway ablation, a delayed complete heart block developed in two patients, and a second-degree AV block developed in two patients. Three patients aged 66, 75, and 76 years died suddenly of unknown cause 4, 16, and 48 months following slow pathway ablation, respectively. CONCLUSIONS: Slow pathway ablation was associated with a significant risk of a delayed higher-degree AV block in patients with AV nodal reentrant tachycardia and a prolonged PR interval at baseline. Retrograde fast pathway ablation for patients with a first-degree AV block and no demonstrable dual pathway physiology was associated with a higher intraprocedural risk of complete AV block but did not result in the development of higher-degree AV block during the long-term follow-up of up to 9 years.
Christopher Reithmann; Thomas Remp; Nico Oversohl; Gerhard Steinbeck
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-06-27
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  17     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-04     Completed Date:  2006-11-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  973-9     Citation Subset:  IM    
Medizinische Klinik I, Klinikum Grosshadern, Universität München, Germany.
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MeSH Terms
Catheter Ablation / methods*
Follow-Up Studies
Heart Block / diagnosis,  physiopathology,  therapy*
Heart Conduction System / physiopathology*
Middle Aged
Retrospective Studies
Risk Factors
Tachycardia, Atrioventricular Nodal Reentry / diagnosis,  physiopathology,  therapy*
Time Factors
Comment In:
J Cardiovasc Electrophysiol. 2006 Sep;17(9):980-2   [PMID:  16948741 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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