Prediction of clinical recurrence of atrioventricular-nodal reentrant tachycardia (AVNRT) after successful slow pathway ablation.
BACKGROUND
Even after successful slow pathway (SP) ablation for atrioventricular-nodal reentrant tachycardia (AVNRT), there may be clinical recurrence in certain patients and it is clinically important to be able to predict that.


RESULTS
In 97 patients with common type AVNRT, the effective refractory period (ERP) of the fast pathway (FP), SP-ERP, and prolongation of the atrio-His (AH) interval (AH) at the time of jump-up phenomenon were investigated. In patients with residual SP, parameters were re-evaluated in a similar manner. SP was successfully ablated and AVNRT was not inducible in all the patients, but residual SP was observed in 54 of the 97 patients, and there was late clinical recurrence in 10 patients (10/54 patients with residual SP and 0/43 without residual SP, p=0.002). The changes in FP-ERP before and after ablation (DeltaFP-ERP) did not differ between recurrent and non-recurrent patients. Among the patients with residual SP, DeltaSP-ERP did not differ between the groups. However, the changes in DeltaAH before and after ablation (DeltaDeltaAH) were larger in non-recurrent (24+/-30 ms) than in the recurrent patients (4+/-7 ms, p=0.042).


CONCLUSIONS
In patients with AVNRT, the residual SP and changes in DeltaAH after successful SP ablation might be useful indices of clinical recurrence.
Hara
Hideyuki
H
Department of Internal Medicine/Cardiology, Kitasato University School of Medicine, Sagamihara, Japan. hideyuki@med.kitasato-u.ac.jp
Niwano
Shinichi
S
Yoshida
Toru
T
Matsuyama
Narihisa
N
Wakisaka
Yuko
Y
Sasaki
Tsuyoshi
T
Kitano
Yoshikazu
Y
Izumi
Tohru
T
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D013611:Tachycardia, Atrioventricular Nodal Reentry