[Radiofrequency ablation of the slow nodal pathway in cases of paroxysmal nodal reentry tachycardia].
BACKGROUND
We describe our experience in the treatment of supraventricular tachycardia due to atrioventricular nodal reentry by radiofrequency catheter ablation of the slow pathway.


METHODS
Thirty-four patients (mean age 52 +/- 13 years) with recurrent drug refractory atrioventricular nodal reentrant tachycardia underwent radiofrequency catheter ablation of slow-pathway as the first procedure. Maximal energy used was 28 +/- 8 W, mean time was 4.4 +/- 2.8 min, and a mean number of 13 +/- 9 discharges per patient.


RESULTS
Of the 34 patients 14 were successfully treated (no slow-pathway conduction, no AV nodal reentrant echo complexes, no inducible tachycardia), 11 were considered as partially successful (no inducible tachycardia, with slow-pathway conduction or echoes) and 9 patients were unsuccessfully treated (all of them underwent fast-pathway ablation with a successful outcome). Eight recurrences were observed during a mean follow-up period of 7 +/- 4 months: One in a patient with previously successful ablation (remained asymptomatic while taking beta-blockers), 6 in patients with first procedure partially successful (all of them underwent effective second slow-pathway ablation) and 1 in a patient with an unsuccessful procedure that underwent fast pathway ablation. A repeated procedure was successful in ablating the slow pathway. None of our patients developed complete atrio-ventricular block. One patient developed cardiac tamponade that needed surgical drainage. At last follow-up all patients are free from tachycardias.


CONCLUSIONS
Slow pathway ablation is an effective method of treatment in patients with atrio-ventricular nodal reentrant tachycardia. Long term success is related to complete abolition of slow pathway conduction.
Brugada
J
J
Servicio de Cardiología, Hospital Clínic i Provincial, Barcelona.
Pelegrín
J
J
Alvarez
B
B
Matas
M
M
Pava
F
F
Navarro-López
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery*; D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors
Ablación por radiofrecuencia de la vía lenta nodal en caso de taquicardia por reentrada nodal paroxística.