Catheter ablation of common atrioventricular nodal reentry tachycardia using the conventional method

  • Amar Alhamdi Sulaimanya Heart Hospital and Alhassani Heart Center, Sulaimanya, Iraq
Keywords: Atrioventricular, nodal reentry tachycardia, Catheter ablation, First line treatment

Abstract

Background and objective: Atrioventricular nodal reentry tachycardia is the commonest type of supraventricular tachycardia referred to the electrophysiology laboratory. It constitutes about two thirds of the supraventricular tachycardia admitted to the emergency department. The mechanism of this tachycardia is reentry. This study aimed to evaluate the efficacy of radiofrequency ablation therapy in atrioventricular nodal reentry tachycardia as the first line treatment using the conventional method.

Methods: The standard technique for the electrophysiological study done to induce tachycardia. Three or four catheters were used. Atrial or ventricular programmed stimulation used to induce the tachycardia. Differentiation of the atrioventricular nodal reentry from atrial tachycardia and atrioventricular tachycardia done by ventricular entrainment. The dry ablation catheter of 4 mm tip used to modify the slow pathway. The appearance of junctional rhythm was a sign of the effective application of the radiofrequency application. The success of ablation was indicated by a failure to induce the tachycardia with repeated programmed stimulation.

Results: Seventy patients with atrioventricular nodal reentry tachycardia were selected from total supraventricular tachycardia cases of 106 patients referred to the catheter lab for radiofrequency ablation. In 85% of the cases atrial programmed stimulation were used to induce the tachycardia and ventricular programmed stimulation and in 15% of the cases. Acute success rate was seen in 68 patients (97%).

Conclusion: Catheter radiofrequency ablation is becoming technically easy, safe, and reliable as first line treatment in the majority of patients with atrioventricular reentry tachycardia.

References

Katritsis GD, Camm AJ, Atrioventricular Nodal Reentry Tachycardia. Circulation 2010; 122:831–40.

Kawaka KF, Josephson ME. Typical AVNRT-an update on mechanisms and therapy. Cardiol Electrophysiol Rev 2002; 6:414–21.

Katritsis GD, Ellenbogen KA, Becker AE. Atrial activation during atrioventrcular nodal reentry tachycardia: studies on retrograde fast pathway conduction. Heart Rhythm 2006; 3:993–1000.

Katritsis DG, Becker A, The circuit of atrioventrcular nodal reentry tachycardia: a proposal. Heart Rhythm 2007; 4:1354–60.

Zipes DP, Lockwood D, Nakagawa H, Jackman WM. Electrophysiological characteristics of atrioventricular nodal reentrant tachycardia: Implications for reentrant circuits. In Zipes DP Jalife J, eds. Cardiac Electrophysiology from cell to Bedside, 5th ed. Philadelphia: Saunders; 2004. P. 615–46.

Jackman WM, Lockwood DL. Double atrial potentials in the His bundle electrograms during slow/fast AV nodal reentrant tachycardia suggests block at tendon of Todaro. Heart Rhythm 2004; 1(1):S47.

Chen J, Anselme F, Smith TW, Zimetbaum P, Epstein LM, Papageorgiou P, et al . Standard right atrial ablation is effective for atrioventrcular nodal reentry with earliest activation in the coronary sinus. J Cardiovasc Electrophysiol 2004; 15:2–7.

Nakagawa H, Jackman WM. Catheter ablation of paroxysmal supraventricular tachycardia. Circulation 2007; 116:2465–78.

Rostock T, Ventura R, Klemm HU, Weiss C, Keitel A, Meinertz T, et al. Efficacy and safety of radiofrequency catheter ablation of atrioventrcular nodal reentrant tachycardia in the elderly. J Cardiovasc Electrophysiol 2005; 16:608–10.

AL-Kinani TA, AL-Khafaji AT, AL-Yacoby A, AL-Mayahi M, AL-Sudani NH, Zeedan SM, et al. Catheter radiofrequency RF-ablation of the slow pathway in atrioventricular nodal reentry tachycardia (AVNRT), first experience in Iraq. TQMJ 2009; 3(1):1–10.

Charme G, Seguel M, Gonsales R. Clinical and electrocardiographical characteristics of patients with atrioventrcular nodal reentry tachycardia who underwent slow pathway ablation. Rev Med Chil 2003; 131:1237–42.

Heidbuchel H, Jackman WM. Characteristics of subforms of AV nodal reentrant tachycardia. Europace 2004; 6:316–29.

Mazur A, Strasberg B. Radiofrequency catheter ablation of atrioventrcular nodal reentry tachycardia. Does the number of catheters matter? IMAJ 2006; 8:497–8.

Delacretaz E. Supraventricular tachycardia. N Eng J Med 2006; 345:10

Schilling RJ. Which patient should be referred to an electrophysiologist: Supraventricular tachycardia. Heart 2002; 87:299–304.

Calkins H, Ajit Kumar VK, Francis J. Catheter ablation of supraventricular tachycardia. Indian Pacing Electrophysiology J 2002; (2):45.

Yaminsharrif A, Davoodi G, Kasemsaeid A, Farhani AV, Ghasanchaib F, Maghaddam M. Radiofrequency catheter ablation of atrioventrcular nodal re-entry tachycardia: success rates and complications during 14 years of experience. J Tehran Heart Cent 2010; 5(2):87–91.

Sciarra L, Mantovan R, Veralto R. Radiofrequency ablation of atrioventrcular reentry tachycardia: the risk of intraprocedural late and long term atrioventrcular block, the Veneton region multicenter experience. Ital Heart J 2002; 3:715–20.

Lakabishvilli Z, Kusneic J, Shokat-Zabrasky R, Mazar A, Battler A, Strasberg B. Junctional rhythm quantity and duration during slow pathway radiofrequency in patients with atrioventrcular nodal reentry tachycardia. Europace 2006; 8(8):588–91.

Bloomstrom –Landqvist C, Scheinman MM, Aliot EM, Joseph S, Calkins H, Camm AJ, et al. ACC.AHA/ESC Guidelines for the management of patients with supraventricular arrhythmias. A report of the American College of Cardiology /American Heart Association task force on practice guidelines, and the European Society of Cardiology Committee for practice Guidelines (Writing committee to develop guidelines for the management of patients with Supraventricular arrhythmias. J Am Coll Cardiol 2003; 42:1493–531.

Lyer R, Hameed S, Vora AM, Locklandwala Y. Radiofrequency ablation a cure for tachyarrhythmias. J Indian Ed Assoc 2000; 98:684–7.

Pasque JL, Scalzi J, Macia JC, Leclercq F, Grolleau-Roux R. Long term safety and efficacy of slow pathway ablation in patients with atrioventrcular reentry tachycardia and preexisting prolonged PR interval. Europace 2006; 8:129–33.

Published
2019-12-18
How to Cite
Alhamdi, A. (2019). Catheter ablation of common atrioventricular nodal reentry tachycardia using the conventional method. Zanco Journal of Medical Sciences (Zanco J Med Sci), 23(3), 322-328. https://doi.org/10.15218/zjms.2019.040
Section
Original Articles