Is electrical stimulation during administration of catecholamines required for the evaluation of success after ablation of atrioventricular node re-entrant tachycardias?
OBJECTIVE
The purpose of this study was to answer the question of whether stimulation after administration of catecholamines is mandatory for identifying unsuccessful ablations of atrioventricular node re-entrant tachycardia (AVNRT).


BACKGROUND
The success of radiofrequency (RF) catheter ablation in AVNRT is confirmed in many centers by noninducibility of tachycardias during stimulation after the administration of catecholamines.


METHODS
A total of 131 patients (81 women and 50 men; mean age 53.6 +/- 13.7 years [range 20 to 77]) were studied. Electrical stimulation was performed without and with the beta-adrenergic amine Orciprenaline (metaproterenol) before and after RF catheter ablation.


RESULTS
In 100 patients (76.3%; confidence interval [CI] 68.1% to 83.3%) an AVNRT was inducible without administration of Orciprenaline. Thirty minutes after the initially successful ablation in 95 patients, tachycardia was inducible in none of these patients, not even after Orciprenaline administration. In the 31 patients (23.7%; CI 16.7% to 31.9%) in whom there was no tachycardia inducible before ablation, Orciprenaline was given, and the stimulation protocol was repeated. In only five patients (3.8%; CI 1.3% to 8.7%) was there still no tachycardia inducible. After an initially successful ablation in the 26 patients who had inducible tachycardias with Orciprenaline before ablation, no tachycardia could be re-induced. After Orciprenaline, the tachycardia was inducible again in only one patient.


CONCLUSIONS
Only patients who require catecholamines for tachycardia induction before ablation need catecholamines for control of the success of the ablation of AVNRT.
Weismüller
Peter
P
Department of Cardiology and Angiology, University Hospital Herne, Ruhr-University Bochum, Herne, Germany. Peter.Weismueller@ruhr-uni-bochum.de
Kuly
Simone
S
Brandts
Bodo
B
Kattenbeck
Klaus
K
Ranke
Carsten
C
Trappe
Hans J
HJ
D000318:Adrenergic beta-Agonists / Q000008:administration & dosage* / Q000009:adverse effects; D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D004558:Electric Stimulation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D009921:Metaproterenol / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012008:Recurrence; D013610:Tachycardia / Q000139:chemically induced / Q000503:physiopathology; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
D000318:Adrenergic beta-Agonists; D009921:Metaproterenol