Targeting the slow pathway for atrioventricular nodal reentrant tachycardia: initial results and long-term follow-up in 379 consecutive patients.
OBJECTIVE
This study is designed to examine the immediate and short-term outcomes of patients who have undergone slow pathway ablation/modification for atrioventricular nodal reentrant tachycardia.


BACKGROUND
Targeting the slow pathway has emerged as the superior form of treatment for atrioventricular nodal reentrant tachycardia. This technique has been found effective and is associated with a low complication rate. However, little is known of the long-term outcome of patients undergoing this procedure.


METHODS
Over a 40-month period the slow pathway was targeted in 379 consecutive patients with proven atrioventricular nodal reentrant tachycardia. The case records of all patients were examined. Accurate follow-up data is available in 96% of patients a mean of 20.6 months after the procedure.


RESULTS
The initial success rate was 97%. The incidence of complete heart block was 0.8% and the mean fluoroscopy duration was 27.3 min. The recurrence rate was 6.9%. Age, number of pulses and fluoroscopy time were positively associated with either initial failure or recurrence. A total of 11.3% of patients were still taking antiarrhythmic medication at follow-up.


CONCLUSIONS
Targeting the slow pathway is an effective form of treatment for atrioventricular nodal reentrant tachycardia. The technique has a high initial success rate, a low complication rate and a low recurrence rate at long-term follow-up. Slow pathway modification is associated with similar success rates and recurrence rates as slow pathway ablation and may confer theoretical long-term benefits.
Clague
J R
JR
Department of Cardiology and Angiology, Westfaelische Wilhelms-Universitaet, Meunster, Germany.
Dagres
N
N
Kottkamp
H
H
Breithardt
G
G
Borggrefe
M
M
D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000453:epidemiology; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000453:epidemiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome