[The catheter ablation of atrioventricular nodal reentry tachycardia: the results of a mixed electrophysiological/anatomical technic].
OBJECTIVE
To describe the results of radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia (AVNRT) by using a mixed electrophysiologic/anatomic mapping technique.


METHODS
Consecutive patients with AVNRT, submitted to AV node modification between November 1992 and March 1995.


METHODS
Cardiology Department at an University Hospital.


METHODS
Twenty consecutive patients with AVNRT were submitted to AV node modification. The ablation technique included two sequential steps. Initially, a detailed electrophysiologic mapping was performed with the ablation catheter, positioned near the coronary sinus ostium, looking for a specific recording: fractionated atrial electrogram, suggestive "slow pathway" potential and a ratio of atrial: ventricular electrogram amplitude > 1. In case of failure, after 5 applications of radiofrequency energy, an anatomic technique was used. The fluoroscopic image, in left anterior oblique projection, was used to guide catheter progression, and the radiofrequency energy applied sequentially in the posterior (P), followed by medium (M) and anterior (A) septal areas if needed. Radiofrequency energy was applied a power of 16-36 watts for 30-60 sec. If a His bundle deflection > 0.0025 mV was recorded, energy was not applied.


RESULTS
Suppression of a AVNRT was initially obtained in 19 patients (95%). A mean of 8.3 +/- 6.1 energy application were required. Mean during of the entire procedure was 142 +/- 45 min and the fluoroscopy duration was 22 +/- 12 min. There were no complications. The location of successful ablation areas was: P in 15 patients, M in three and A in one. After a mean follow up of 10 +/- 6 months, two patients had recurrence of AVNRT. A second procedure was successful in the initially failed patient and in these two recurrences.


CONCLUSIONS
A mixed electrophysiologic/anatomic mapping technique to perform radiofrequency catheter ablation of AVNRT was associated with high efficacy and no complications.
D000328:Adult; D002304:Cardiac Pacing, Artificial / Q000379:methods / Q000706:statistics & numerical data; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology / Q000601:surgery*
Ablação por cateter de taquicardia de reentrada nodal aurículo-ventricular: resultados de técnica mista--electrofisiológica/anatómica.