Clinical management of patients with atrioventricular nodal reentrant tachycardia.
A broad array of therapeutic options is currently available for the management of patients with AV nodal reentrant tachycardia. While acute termination of tachycardias is readily achieved, either by vagal maneuvers or intravenous medication, the decision to embark on a long-term therapeutic plan to prevent recurrences must be clinically individualized. When a chronic pharmacologic approach is desired, electrophysiologic testing is invaluable for confirming the diagnosis and selecting appropriate medication. However, the growing awareness of potential proarrhythmic effects and the inconvenience and expense of lifelong drug therapy, coupled with other advances in the field, have made nonpharmacologic approaches more attractive. This is especially so for symptomatic younger patients. The definitive cure rates achievable with surgery are now being approached by transcatheter AV nodal modification procedures that ablate AV nodal reentrant tachycardia while preserving anterograde AV nodal conduction. Over the next decade, it is likely that the latter technique will become widely used for the long-term management of symptomatic AV nodal reentrant tachycardia.
Wayne State University, Detroit, Michigan.
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CD
Schuger
R T
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Steinman
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Meissner
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Mosteller
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Lehmann
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D004564:Electrocoagulation; D004594:Electrophysiology; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D010138:Pacemaker, Artificial; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000628:therapy*; D013617:Tachycardia, Supraventricular / Q000628:therapy*
D000889:Anti-Arrhythmia Agents