[Long-term outcome of AV node modulation in 387 consecutive patients with AV nodal reentrant tachycardia].
Aim of this study was to assess the long-term results of AV-node modulation in patients with AV nodal reetrant tachycardia.


METHODS
From December 1991 until September 1999, AV node modulation (ablation of the fast pathway or ablation/modification of the slow pathway) was performed in 387 consecutive patients with clinically apparent AV nodal reentrant tachycardia. Follow-up data was available in 95% of patients with a mean of 41 +/- 26 months after ablation.


RESULTS
Acute success rate was 97%. During long-term follow-up recurrence rate was 7.4% without any difference between fast and slow pathway ablation. Recurrence occurred in 23% of patients with persistent dual AV node physiology after ablation (modification of the slow pathway) in contrast to 3% without dual AV node physiology (ablation of the slow pathway) (p = 0.002). The presence of a dual AV node physiology after slow pathway modulation was the only predictor of recurrence during long-term follow-up. The complication rate was 5.7%. The incidence of complete heart block was 1% without any difference between fast and slow pathway ablation.


CONCLUSIONS
Catheter modulation of the AV node for the treatment of AV nodal reentrant tachycardia is effective and safe. During long-term follow-up, the recurrence rate was low. Modulation of the slow pathway is associated with a significantly higher recurrence rate than ablation of the slow pathway.
Herzzentrum Ludwigshafen Bremserstr. 79 67063 Ludwigshafen, Germany. Harald.Schwacke@klilu.de
H
H
Schwacke
A
A
Brandt
M
M
Rameken
M
M
Vater
F
F
Fischer
J
J
Senges
K
K
Seidl
D000328:Adult; D000368:Aged; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology; D012008:Recurrence; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*