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Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval.
Eur Heart J. 2001 Jan; 22(1):89-95.EH

Abstract

AIMS

The objective of this prospective study was to assess risk factors for the development of atrioventricular block following slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval.

METHODS AND RESULTS

Of 346 consecutive patients with atrioventricular nodal reentrant tachycardia undergoing slow pathway modification, 18 patients (62 +/- 7 years; five females) were found to have a prolonged PR interval prior to ablation. Total elimination of the functional slow pathway was assumed if the antegrade effective refractory period following slow pathway modification was longer than the cycle length of atrioventricular nodal reentrant tachycardia. To detect atrioventricular node conduction disturbances, 24-h Holter recordings were performed 1 day prior to slow pathway modification, and 1 day, 1 week, 1, 3 and 6 months after the procedure. Six patients developed late atrioventricular block. The incidence of delayed atrioventricular block following successful slow pathway modification was higher in patients with, compared to patients without, prolonged PR interval at baseline (6/18 vs 0/328, P < .001). In the former group, the antegrade effective refractory period was longer in patients with, compared to those without, a delayed atrioventricular block (492 +/- 150 ms vs 332 +/- 101 ms, P < 0.05). The incidence of delayed atrioventricular block was higher in patients with total elimination of the slow pathway compared to patients without (5/7 vs 1/11, P < 0.01).

CONCLUSIONS

Slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a prolonged PR interval is highly effective. However, there is a significant risk of development of delayed atrioventricular block, particularly when the procedure results in total elimination of the slow pathway.

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Publisher Full Text

Authors+Show Affiliations

Li YG
Department of Internal Medicine, Divison of Cardiology, J. W. Goethe University, Frankfurt, Germany.
Grönefeld G
No affiliation info available
Bender B
No affiliation info available
Machura C
No affiliation info available
Hohnloser SH
No affiliation info available

MeSH

Case-Control StudiesCatheter AblationElectrocardiography, AmbulatoryElectrophysiologic Techniques, CardiacFemaleFollow-Up StudiesHeart BlockHeart Conduction SystemHumansIncidenceMaleMiddle AgedPostoperative ComplicationsProspective StudiesRisk FactorsTachycardia, Atrioventricular Nodal Reentry

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11133214

Citation

Li, Y G., et al. "Risk of Development of Delayed Atrioventricular Block After Slow Pathway Modification in Patients With Atrioventricular Nodal Reentrant Tachycardia and a Pre-existing Prolonged PR Interval." European Heart Journal, vol. 22, no. 1, 2001, pp. 89-95.
Li YG, Grönefeld G, Bender B, et al. Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval. Eur Heart J. 2001;22(1):89-95.
Li, Y. G., Grönefeld, G., Bender, B., Machura, C., & Hohnloser, S. H. (2001). Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval. European Heart Journal, 22(1), 89-95.
Li YG, et al. Risk of Development of Delayed Atrioventricular Block After Slow Pathway Modification in Patients With Atrioventricular Nodal Reentrant Tachycardia and a Pre-existing Prolonged PR Interval. Eur Heart J. 2001;22(1):89-95. PubMed PMID: 11133214.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of development of delayed atrioventricular block after slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval. AU - Li,Y G, AU - Grönefeld,G, AU - Bender,B, AU - Machura,C, AU - Hohnloser,S H, PY - 2001/1/3/pubmed PY - 2001/9/14/medline PY - 2001/1/3/entrez SP - 89 EP - 95 JF - European heart journal JO - Eur Heart J VL - 22 IS - 1 N2 - AIMS: The objective of this prospective study was to assess risk factors for the development of atrioventricular block following slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a pre-existing prolonged PR interval. METHODS AND RESULTS: Of 346 consecutive patients with atrioventricular nodal reentrant tachycardia undergoing slow pathway modification, 18 patients (62 +/- 7 years; five females) were found to have a prolonged PR interval prior to ablation. Total elimination of the functional slow pathway was assumed if the antegrade effective refractory period following slow pathway modification was longer than the cycle length of atrioventricular nodal reentrant tachycardia. To detect atrioventricular node conduction disturbances, 24-h Holter recordings were performed 1 day prior to slow pathway modification, and 1 day, 1 week, 1, 3 and 6 months after the procedure. Six patients developed late atrioventricular block. The incidence of delayed atrioventricular block following successful slow pathway modification was higher in patients with, compared to patients without, prolonged PR interval at baseline (6/18 vs 0/328, P < .001). In the former group, the antegrade effective refractory period was longer in patients with, compared to those without, a delayed atrioventricular block (492 +/- 150 ms vs 332 +/- 101 ms, P < 0.05). The incidence of delayed atrioventricular block was higher in patients with total elimination of the slow pathway compared to patients without (5/7 vs 1/11, P < 0.01). CONCLUSIONS: Slow pathway modification in patients with atrioventricular nodal reentrant tachycardia and a prolonged PR interval is highly effective. However, there is a significant risk of development of delayed atrioventricular block, particularly when the procedure results in total elimination of the slow pathway. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/11133214/Risk_of_development_of_delayed_atrioventricular_block_after_slow_pathway_modification_in_patients_with_atrioventricular_nodal_reentrant_tachycardia_and_a_pre_existing_prolonged_PR_interval_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1053/euhj.2000.2182 DB - PRIME DP - Unbound Medicine ER -