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Catheter ablation of retrograde fast pathway in patients with atrioventricular nodal reentrant supraventricular tachycardia.
Indian Heart J. 1992 Nov-Dec; 44(6):359-64.IH

Abstract

Atrioventricular (AV) nodal reentrant tachycardia is a common cause of supraventricular tachycardia. The present study describes catheter ablation of this form of tachycardia in 23 patients using direct current shocks. The aim of ablation was to abolish conduction through the retrograde pathway while preserving the anterograde conduction. All patients had symptomatic, drug resistant, slow-fast variety of dual atrioventricular nodal reentrant tachycardia. Using the retrograde atrial activation in the His bundle catheter as the reference, the optimal ablation site was selected by positioning an electrode catheter to obtain atrial activation synchronous with or earlier than the atrial activation at the reference electrode. Shocks of 100-300 joules were delivered at this site resulting in blockade of retrograde conduction in all patients. Ventriculo-atrial conduction studied 24 hours after the procedure was still absent in 16, modified in 2 and resumed in 3 patients. Two patients developed permanent complete heart block and were given pacemakers. At repeat electrophysiologic study performed after 2-4 months in 10 patients, the supraventricular tachycardia could not be induced. The AH interval was 67 +/- 10 msec during control study and to 115 +/- 39 msec at restudy (p < 0.001). The ventriculo-atrial conduction was absent in 7 cases and had been modified in 1 case. Over a follow up period of 1-30 months (mean 10.8 +/- 7.1 mo) 17 patients (73%) remained free of the arrhythmia without medication or pacemaker. Three other patients were easily controlled with digoxin. Thus, catheter modification of AV node results in permanent cure of the AV nodal tachycardia in majority of patients.

Authors+Show Affiliations

Department of Cardiology, G B Pant Hospital, New Delhi.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

1307082

Citation

Sethi, K K., et al. "Catheter Ablation of Retrograde Fast Pathway in Patients With Atrioventricular Nodal Reentrant Supraventricular Tachycardia." Indian Heart Journal, vol. 44, no. 6, 1992, pp. 359-64.
Sethi KK, Singh B, Nair M, et al. Catheter ablation of retrograde fast pathway in patients with atrioventricular nodal reentrant supraventricular tachycardia. Indian Heart J. 1992;44(6):359-64.
Sethi, K. K., Singh, B., Nair, M., Kalra, G. S., Arora, R., & Khalilullah, M. (1992). Catheter ablation of retrograde fast pathway in patients with atrioventricular nodal reentrant supraventricular tachycardia. Indian Heart Journal, 44(6), 359-64.
Sethi KK, et al. Catheter Ablation of Retrograde Fast Pathway in Patients With Atrioventricular Nodal Reentrant Supraventricular Tachycardia. Indian Heart J. 1992 Nov-Dec;44(6):359-64. PubMed PMID: 1307082.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Catheter ablation of retrograde fast pathway in patients with atrioventricular nodal reentrant supraventricular tachycardia. AU - Sethi,K K, AU - Singh,B, AU - Nair,M, AU - Kalra,G S, AU - Arora,R, AU - Khalilullah,M, PY - 1992/11/1/pubmed PY - 1992/11/1/medline PY - 1992/11/1/entrez SP - 359 EP - 64 JF - Indian heart journal JO - Indian Heart J VL - 44 IS - 6 N2 - Atrioventricular (AV) nodal reentrant tachycardia is a common cause of supraventricular tachycardia. The present study describes catheter ablation of this form of tachycardia in 23 patients using direct current shocks. The aim of ablation was to abolish conduction through the retrograde pathway while preserving the anterograde conduction. All patients had symptomatic, drug resistant, slow-fast variety of dual atrioventricular nodal reentrant tachycardia. Using the retrograde atrial activation in the His bundle catheter as the reference, the optimal ablation site was selected by positioning an electrode catheter to obtain atrial activation synchronous with or earlier than the atrial activation at the reference electrode. Shocks of 100-300 joules were delivered at this site resulting in blockade of retrograde conduction in all patients. Ventriculo-atrial conduction studied 24 hours after the procedure was still absent in 16, modified in 2 and resumed in 3 patients. Two patients developed permanent complete heart block and were given pacemakers. At repeat electrophysiologic study performed after 2-4 months in 10 patients, the supraventricular tachycardia could not be induced. The AH interval was 67 +/- 10 msec during control study and to 115 +/- 39 msec at restudy (p < 0.001). The ventriculo-atrial conduction was absent in 7 cases and had been modified in 1 case. Over a follow up period of 1-30 months (mean 10.8 +/- 7.1 mo) 17 patients (73%) remained free of the arrhythmia without medication or pacemaker. Three other patients were easily controlled with digoxin. Thus, catheter modification of AV node results in permanent cure of the AV nodal tachycardia in majority of patients. SN - 0019-4832 UR - https://www.unboundmedicine.com/medline/citation/1307082/Catheter_ablation_of_retrograde_fast_pathway_in_patients_with_atrioventricular_nodal_reentrant_supraventricular_tachycardia_ DB - PRIME DP - Unbound Medicine ER -