[Endocavitary ablation of nodal reentrant tachycardia].
Atrioventricular nodal reentrant tachycardias which, for a long time, could only be treated medically, may now benefit from catheter ablation. The rapid retrograde pathway was an effective initial target but carried a risk of complete atrioventricular block of about 10%. Nowadays, most operators deliver the radiofrequency energy (endocavitary cautery) to the slow nodal pathway. Different techniques of guidance (anatomical, electrophysiological, rapid potential, slow potential) are associated with high success rates: 90 to 100%. However, experimental studies suggest that the slow potentials arise from transitional cells within the tachycardia circuit (the anatomical substrate of the slow pathway). There is still a risk of complete atrioventricular block (1 to 5%) which should be clearly explained to patients referred for ablation of this constantly benign arrhythmia.
Jaïs
P
P
Hôpital Cardiologique du Haut-Lévêque.
Haïssaguerre
M
M
Gencel
L
L
Shah
D C
DC
Le Métayer
P
P
Clémenty
J
J
D002036:Bundle of His / Q000473:pathology / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D004562:Electrocardiography; D005500:Follow-Up Studies; D006346:Heart Septum / Q000503:physiopathology; D006801:Humans; D012008:Recurrence; D012848:Sinoatrial Block / Q000209:etiology; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
Ablation endocavitaire des tachycardies par réentrée nodale.