title: Slow pathway modification in patients presenting with only two consecutive AV nodal echo beats.
abstract: Slow pathway modification (SPM) is the therapy of choice for AV-nodal reentry tachycardia (AVNRT). When AVNRT is not inducible, empirical ablation can be considered, however, the outcome in patients with two AV nodal echo beats (AVNEBs) is unknown.
  
  
  
  Out of a population of 3003 patients who underwent slow pathway modification at our institution between 1993 and 2013, we retrospectively included 32 patients with a history of symptomatic tachycardia, lack of paroxysmal supraventricular tachycardia (pSVT) inducibility but occurrence of two AVNEBs.
  
  
  
  pSVT documentation by electrocardiography (ECG) was present in 20 patients. The procedural endpoint was inducibility of less than two AVNEBs. This was reached in 31 (97%) patients. Long-term success was assessed by a telephone questionnaire (follow-up time 63±9 months). A total 94% of the patients benefited from the procedure (59% freedom from symptoms; 34% improvement in symptoms). Among those patients in whom ECG documentation was not present, 100% benefited (58% freedom from symptoms, 42% improvement).
  
  
  
  This is the first collective analysis of a group of patients presenting with symptoms of pSVT and inducibility of only two AVNEBs. Procedural success and clinical long-term follow-up were in the range of the reported success rates of slow pathway modification of inducible AVNRT, independent of whether ECG documentation was present. Thus, SPM is a safe and effective therapy in patients with two AVNEBs.
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Felix K
authors.initials: FK
authors.lastname: Wegner
authors.affiliation: Division of Cardiology, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Silvano
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Bögeholz
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Leitz
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Gerrit
authors.initials: G
authors.lastname: Frommeyer
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Dirk G
authors.initials: DG
authors.lastname: Dechering
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zellerhoff
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Kochhäuser
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Lange
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Köbe
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Wasmer
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Gerold
authors.initials: G
authors.lastname: Mönnig
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.affiliation: Division of Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany. Electronic address: christian.pott@ukmuenster.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Pott
mesh_terms: D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D013614:Tachycardia, Paroxysmal / Q000601:surgery*; D013617:Tachycardia, Supraventricular / Q000601:surgery*
keywords: AV node; AV-nodal reentry tachycardia; Electrophysiology; Empirical slow pathway modification; Supraventricular tachycardia