Slow pathway modification in patients presenting with only two consecutive AV nodal echo beats.

Abstract

BACKGROUND:

Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown.

METHODS:

Out of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs.

RESULTS:

pSVT documentation by electrocardiography (ECG) was present in 20 patients. The procedural endpoint was inducibility of less than two AVNEBs. This was reached in 31 (97%) patients. Long-term success was assessed by a telephone questionnaire (follow-up time 63±9 months). A total 94% of the patients benefited from the procedure (59% freedom from symptoms; 34% improvement in symptoms). Among those patients in whom ECG documentation was not present, 100% benefited (58% freedom from symptoms, 42% improvement).

CONCLUSION:

This is the first collective analysis of a group of patients presenting with symptoms of pSVT and inducibility of only two AVNEBs. Procedural success and clinical long-term follow-up were in the range of the reported success rates of slow pathway modification of inducible AVNRT, independent of whether ECG documentation was present. Thus, SPM is a safe and effective therapy in patients with two AVNEBs.

• Authors: Felix K Wegner, Maria Silvano, Nils Bögeholz, Patrick R Leitz, Gerrit Frommeyer, Dirk G Dechering, Stephan Zellerhoff, Simon Kochhäuser, Philipp S Lange, Julia Köbe, Kristina Wasmer, Gerold Mönnig, Lars Eckardt, Christian Pott
• Journal: Journal of cardiology (J Cardiol) Vol. 69 Issue 2 Pg. 471-475 (02 2017) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 27021469 (Publication Type: Journal Article)
• Copyright: Copyright © 2016. Published by Elsevier Ltd.

Topics

• Catheter Ablation
• Electrocardiography
• Female
• Humans
• Male
• Middle Aged
• Patient Outcome Assessment
• Retrospective Studies
• Tachycardia, Atrioventricular Nodal Reentry (surgery)
• Tachycardia, Paroxysmal (surgery)
• Tachycardia, Supraventricular (surgery)