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Radiofrequency ablation of atrioventricular nodal reentrant tachycardia: the risk of intraprocedural, late and long-term atrioventricular block. The Veneto Region multicenter experience.
Ital Heart J. 2002 Dec; 3(12):715-20.IH

Abstract

BACKGROUND

Radiofrequency ablation of either the fast or the slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT) can be complicated by transient or permanent atrioventricular (AV) block. Little is known about the possibility of AV block occurring during the first weeks after the procedure and nothing about the risk of AV block during the long-term follow-up.

METHODS

To clarify these latter points, from February 1990 to December 2000 we enrolled 510 consecutive patients (56 males, 454 females, mean age 55 +/- 16 years) with AVNRT. The target of ablation was the fast pathway in 29 patients (group A) and the slow pathway in 474 (group B), while in 7 (group C) the slow pathway was targeted after unsuccessful fast pathway ablation. Follow-up was available for 488/510 (95.6%). The length of follow-up was 8.2 +/- 2.4 years in group A, 3.4 +/- 2.4 years in group B (83 group B patients had a follow-up > 6 years: 7.3 +/- 0.8 years), and 7.3 +/- 2.4 years in group C.

RESULTS

The success rates were 93, 99 and 100% in the three groups respectively. Intraprocedural II-III degree AV block occurred in 6/29 patients (20%) of group A, in 11/474 patients (2.3%) of group B and in 3/7 patients (42%) of group C. In all patients of groups A and C, the II-III degree AV block was transient. In contrast, in 6/474 patients of group B (1.2%, 2 II degree and 4 III degree AV block) the block still persisted at the end of the procedure. Within 7 days of the procedure, a late persistent II-III degree AV block developed in 1/29 patients (3.4%, 1 III degree) of group A, in 1/474 patients (0.2%, 1 II degree) of group B and in 0/7 patients of group C. In 1 out of 6 patients of group B who developed an intraprocedural persistent AV block, 1:1 conduction resumed within the first week. A definitive pacemaker was implanted for permanent III degree AV block in 1/29 patients of group A (3.4%), in 4/474 patients (0.8%) of group B and in 0/7 patients of group C. In the remaining 2/474 group B patients with permanent II degree AV block, a pacemaker was not implanted. During follow-up, no patient presented with a II-III degree AV block related to the ablation. In group B, 2 patients received a pacemaker implant for reasons unrelated to the ablation (1 sick sinus syndrome, 1 progressive intraventricular conduction disease).

CONCLUSIONS

The risk of permanent AV block in patients who undergo fast or slow pathway ablation is low and limited to the procedure or to the days immediately after the procedure, and there is no risk of II-III degree AV block during long-term follow-up.

Authors+Show Affiliations

Cardiology Unit, Civic Hospital, Conegliano, TV, Italy. pdelise@ulss7pieve.veneto.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

12611122

Citation

Delise, Pietro, et al. "Radiofrequency Ablation of Atrioventricular Nodal Reentrant Tachycardia: the Risk of Intraprocedural, Late and Long-term Atrioventricular Block. the Veneto Region Multicenter Experience." Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, vol. 3, no. 12, 2002, pp. 715-20.
Delise P, Sitta N, Zoppo F, et al. Radiofrequency ablation of atrioventricular nodal reentrant tachycardia: the risk of intraprocedural, late and long-term atrioventricular block. The Veneto Region multicenter experience. Ital Heart J. 2002;3(12):715-20.
Delise, P., Sitta, N., Zoppo, F., Corò, L., Verlato, R., Mantovan, R., Sciarra, L., Cannarozzo, P., Fantinel, M., Bonso, A., Bertaglia, E., & D'Este, D. (2002). Radiofrequency ablation of atrioventricular nodal reentrant tachycardia: the risk of intraprocedural, late and long-term atrioventricular block. The Veneto Region multicenter experience. Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, 3(12), 715-20.
Delise P, et al. Radiofrequency Ablation of Atrioventricular Nodal Reentrant Tachycardia: the Risk of Intraprocedural, Late and Long-term Atrioventricular Block. the Veneto Region Multicenter Experience. Ital Heart J. 2002;3(12):715-20. PubMed PMID: 12611122.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency ablation of atrioventricular nodal reentrant tachycardia: the risk of intraprocedural, late and long-term atrioventricular block. The Veneto Region multicenter experience. AU - Delise,Pietro, AU - Sitta,Nadir, AU - Zoppo,Franco, AU - Corò,Leonardo, AU - Verlato,Roberto, AU - Mantovan,Roberto, AU - Sciarra,Luigi, AU - Cannarozzo,Pietro, AU - Fantinel,Mauro, AU - Bonso,Aldo, AU - Bertaglia,Emanuele, AU - D'Este,Daniele, PY - 2003/3/4/pubmed PY - 2003/4/23/medline PY - 2003/3/4/entrez SP - 715 EP - 20 JF - Italian heart journal : official journal of the Italian Federation of Cardiology JO - Ital Heart J VL - 3 IS - 12 N2 - BACKGROUND: Radiofrequency ablation of either the fast or the slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT) can be complicated by transient or permanent atrioventricular (AV) block. Little is known about the possibility of AV block occurring during the first weeks after the procedure and nothing about the risk of AV block during the long-term follow-up. METHODS: To clarify these latter points, from February 1990 to December 2000 we enrolled 510 consecutive patients (56 males, 454 females, mean age 55 +/- 16 years) with AVNRT. The target of ablation was the fast pathway in 29 patients (group A) and the slow pathway in 474 (group B), while in 7 (group C) the slow pathway was targeted after unsuccessful fast pathway ablation. Follow-up was available for 488/510 (95.6%). The length of follow-up was 8.2 +/- 2.4 years in group A, 3.4 +/- 2.4 years in group B (83 group B patients had a follow-up > 6 years: 7.3 +/- 0.8 years), and 7.3 +/- 2.4 years in group C. RESULTS: The success rates were 93, 99 and 100% in the three groups respectively. Intraprocedural II-III degree AV block occurred in 6/29 patients (20%) of group A, in 11/474 patients (2.3%) of group B and in 3/7 patients (42%) of group C. In all patients of groups A and C, the II-III degree AV block was transient. In contrast, in 6/474 patients of group B (1.2%, 2 II degree and 4 III degree AV block) the block still persisted at the end of the procedure. Within 7 days of the procedure, a late persistent II-III degree AV block developed in 1/29 patients (3.4%, 1 III degree) of group A, in 1/474 patients (0.2%, 1 II degree) of group B and in 0/7 patients of group C. In 1 out of 6 patients of group B who developed an intraprocedural persistent AV block, 1:1 conduction resumed within the first week. A definitive pacemaker was implanted for permanent III degree AV block in 1/29 patients of group A (3.4%), in 4/474 patients (0.8%) of group B and in 0/7 patients of group C. In the remaining 2/474 group B patients with permanent II degree AV block, a pacemaker was not implanted. During follow-up, no patient presented with a II-III degree AV block related to the ablation. In group B, 2 patients received a pacemaker implant for reasons unrelated to the ablation (1 sick sinus syndrome, 1 progressive intraventricular conduction disease). CONCLUSIONS: The risk of permanent AV block in patients who undergo fast or slow pathway ablation is low and limited to the procedure or to the days immediately after the procedure, and there is no risk of II-III degree AV block during long-term follow-up. SN - 1129-471X UR - https://www.unboundmedicine.com/medline/citation/12611122/Radiofrequency_ablation_of_atrioventricular_nodal_reentrant_tachycardia:_the_risk_of_intraprocedural_late_and_long_term_atrioventricular_block__The_Veneto_Region_multicenter_experience_ DB - PRIME DP - Unbound Medicine ER -