Catheter Ablation of Atypical Atrioventricular Nodal Reentrant Tachycardia

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  • Demosthenes G. Katritsis
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Joseph E. Marine
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Fernando M. Contreras
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Akira Fujii
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Rakesh Latchamsetty
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Konstantinos C. Siontis
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • George D. Katritsis
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Theodoros Zografos
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Roy M. John
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Lawrence M. Epstein
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Gregory F. Michaud
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Elad Anter
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Ali Sepahpour
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Edward Rowland
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Alfred E. Buxton
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Hugh Calkins
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Fred Morady
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • William G. Stevenson
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...
  • Mark E. Josephson
    From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London,...

Abstract

<jats:sec> <jats:title>Background:</jats:title> <jats:p>Because of its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method has not been established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>We studied 2079 patients with AVNRT subjected to slow pathway ablation. In 113 patients, mean age 48.5±18.1 years, 68 female, atypical AVNRT or coexistent atypical and typical AVNRT without other concomitant arrhythmia was diagnosed. Ablation data and outcomes were compared with a group of age- and sex-matched control patients with typical AVNRT.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p> Fluoroscopy and radiofrequency current delivery times were not different in the atypical and typical groups, 20.3±12.2 versus 20.8±12.9 minutes ( <jats:italic>P</jats:italic> =0.730) and 5.9±5.0 versus 5.5±4.5 minutes ( <jats:italic>P</jats:italic> =0.650), respectively. Slow pathway ablation was accomplished from the right septum in 110 patients, and from the left septum in 3 patients, in the atypical group. There was no need for additional ablation lesions at other anatomic sites, and no cases of atrioventricular block were encountered. Recurrence rates of the arrhythmia were 5.6% in the atypical (6/108 patients) and 1.8% in the typical (2/111 patients) groups in the next 3 months following ablation ( <jats:italic>P</jats:italic> =0.167). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Conventional ablation at the anatomic area of the slow pathway is the therapy of choice for symptomatic AVNRT, regardless of whether the typical or atypical form is present.</jats:p> </jats:sec>

Journal

  • Circulation

    Circulation 134 (21), 1655-1663, 2016-11-22

    Ovid Technologies (Wolters Kluwer Health)

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