Prognostic significance of transient complete atrioventricular block during radiofrequency ablation of atrioventricular node reentrant tachycardia.
One hundred eighty-six consecutive patients underwent radiofrequency ablation and were divided into 2 groups: group 1 included 19 patients (13 women, mean age 50 +/- 15 years) with transient atrioventricular (AV) block during the procedure. The duration of AV block ranged from 4 seconds to 30 minutes (mean 2.8 +/- 7.0 minutes); and group 2 included 167 patients (142 women, mean age 40 +/- 17 years) without transient AV block. Follow-up was 8.6 +/- 8.3 months in group 1 and 10.1 +/- 9.4 months in group 2. No significant differences were observed between the 2 groups concerning the ablation approach (fast or slow pathway), the number of radiofrequency applications, and recurrences of tachycardia. Four patients from group 1 who underwent fast pathway ablation developed late complete AV block, whereas no patient in group 2 had such a complication (p = 0.0001). Late complete AV block occurred 20 hours, 6 days, 1 month, and 25 days after ablation, respectively, and was not related to the duration of transient AV block. Another patient from group 1 developed an asymptomatic 2:1 AV block during exercise, 3 months after slow pathway ablation. Transient AV block, a common finding occurring as often during fast as during slow pathway ablation, did not preclude recurrences of tachycardia but was associated with late complete AV block.
Fenelon
G
G
Cardiovascular Research, O.L.V. Hospital, Aalst, Belgium.
d'Avila
A
A
Malacky
T
T
Brugada
P
P
D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome