Transvenous Radiofrequency Ablation Theraphy as an Effective and Safe Method for The Treatment of The Slow Pathway Of Atrioventricular Nodal Re-Entrant Tachycardia

Abstract

Background: The typical atrioventricular nodal re-entrant tachycardia (AVNRT) can be cured with the slow pathway ablation. In this study, we have analyzed a consecutive series of patients with typical AVNRT who underwent slow-pathway ablation which is a safe, effective and reproducible strategy using radiofrequency (RF) energy. Patients and Method: Fifty consecutive patients with symptomatic drug-resistant typical (slow-fast) AVNRT underwent an invasive electrophysiology study and RF ablation (RFA) of slow conduction pathway within atrioventricular (AV) node. The endpoints of ablation were induction of a retrogradely conducted junctional rhythm, and non-inducibility of AVNRT on atropine. Results: Fifty consecutive patients (age: 42.5 ± 15.4 years, body mass index: 25.56 ± 3.67 kg/m2, waist/hip ratio: 0.84 ± 7.164E-02, systolic blood pressure: 119.20 ± 13.57 mmHg, diastolic blood pressure: 74.40 ± 8.06 mmHg, rest heart rate: 76.20 ± 7.25 beat/min) with slow-fast AVNRT (40 women, 10 men) were ablated. AVNRT was induced during electrophysiological study. RFA successfully eliminated tachyarrhythmia in 50 (100%) patients. The AH interval was decreased in the post-ablation period as compared with pre-ablation period and no immediate conduction disturbances. Procedure and fluoroscopy times were 65.4 ± 19.0 and 13.4 ± 3.6 min respectively. No patient presented with AV block of any degree. Conclusions: The transvenous radiofrequency ablation therapy is a safe and effective approach for AVNRT, but care should be taken to use it in a way with full understanding of its possibilities and limitations, otherwise it could lead to disappointing results.