[Incidence and prognosis of atrioventricular block induced by radiofrequency ablation of intranodal reentrant tachycardia. A multicenter study].
The object of this study was to assess the incidence and significance of atrioventricular block (AVB) induced by radiofrequency ablation of intranodal reentrant tachycardias. The study population was 18 patients aged 44 to 83, selected from a total population of 144 patients treated for recurrent, refractory tachycardias. These patients developed complete AVB (9 cases), 2nd degree ABV (3 cases) and 1st degree AVB (6 cases) either immediately or in the chronic phase after radiofrequency ablation. The outcomes were as follows: 1. In the 9 patients with complete AVB, the block regressed in a period ranging from 7 seconds to 5 minutes. It recurred as complete AVB 1 to 4 days later in 2 patients, and regressed again after a maximum of 10 days. One 47 year old woman had definitive complete AVB; 2. In the 3 patients with 2nd degree AVB, the block regressed within 7 days; 3. In the 6 cases of 1st degree AVB, 2 patients developed transient complete AVB the following day. The possible causes of AVB were: increased vagal tone in 1 case, ablation of the rapid pathway located in a postero-septal site in 8 cases and, in the remainder, pre-existing conduction defects. The authors conclude that transient complete AVB is common and usually has a good prognosis. Definitive complete AVB is a rare but possible (0.7%) complication of radiofrequency ablation of reentrant intranodal tachycardias; other forms of AVB generally regress quickly and, although they may recur within days, they carry a good prognosis in the following months. However, long-term follow-up remains necessary.
Brembilla-Perrot
B
B
Service de cardiologie, CHU de Brabois, Vandoeuvre.
Houriez
P
P
Beurrier
D
D
Jacquemin
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011379:Prognosis; D012008:Recurrence; D012075:Remission, Spontaneous; D013615:Tachycardia, Sinoatrial Nodal Reentry / Q000601:surgery*; D013997:Time Factors