title: Catheter Ablation of Atypical Atrioventricular Nodal Reentrant Tachycardia.
abstract: BACKGROUND
  Because of its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method has not been established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT.
  
  
  METHODS
  We studied 2079 patients with AVNRT subjected to slow pathway ablation. In 113 patients, mean age 48.5±18.1 years, 68 female, atypical AVNRT or coexistent atypical and typical AVNRT without other concomitant arrhythmia was diagnosed. Ablation data and outcomes were compared with a group of age- and sex-matched control patients with typical AVNRT.
  
  
  RESULTS
  Fluoroscopy and radiofrequency current delivery times were not different in the atypical and typical groups, 20.3±12.2 versus 20.8±12.9 minutes (P=0.730) and 5.9±5.0 versus 5.5±4.5 minutes (P=0.650), respectively. Slow pathway ablation was accomplished from the right septum in 110 patients, and from the left septum in 3 patients, in the atypical group. There was no need for additional ablation lesions at other anatomic sites, and no cases of atrioventricular block were encountered. Recurrence rates of the arrhythmia were 5.6% in the atypical (6/108 patients) and 1.8% in the typical (2/111 patients) groups in the next 3 months following ablation (P=0.167).
  
  
  CONCLUSIONS
  Conventional ablation at the anatomic area of the slow pathway is the therapy of choice for symptomatic AVNRT, regardless of whether the typical or atypical form is present.
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.). dkatrits@bidmc.harvard.edu dkatrits@dgkatritsis.gr.
authors.forename: Demosthenes G
authors.initials: DG
authors.lastname: Katritsis
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Marine
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Contreras
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Akira
authors.initials: A
authors.lastname: Fujii
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Rakesh
authors.initials: R
authors.lastname: Latchamsetty
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Konstantinos C
authors.initials: KC
authors.lastname: Siontis
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: George D
authors.initials: GD
authors.lastname: Katritsis
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Theodoros
authors.initials: T
authors.lastname: Zografos
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Roy M
authors.initials: RM
authors.lastname: John
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Epstein
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Gregory F
authors.initials: GF
authors.lastname: Michaud
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Elad
authors.initials: E
authors.lastname: Anter
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Ali
authors.initials: A
authors.lastname: Sepahpour
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Edward
authors.initials: E
authors.lastname: Rowland
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Alfred E
authors.initials: AE
authors.lastname: Buxton
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Hugh
authors.initials: H
authors.lastname: Calkins
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: William G
authors.initials: WG
authors.lastname: Stevenson
authors.affiliation: From Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (D.G.K., F.M.C., E.A., A.E.B., M.E.J.); Athens Euroclinic, Greece (D.G.K., T.Z.); Johns Hopkins Hospital, Baltimore, MD (J.E.M., H.C.); Brigham and Women's Hospital, Harvard Medical School, Boston, MA (A.F., R.M.J., L.M.E., G.F.M., W.G.S.); University of Michigan Health System, Ann Arbor (R.L., K.C.S., F.M.); The Oxford University Clinical Academic Graduate School, United Kingdom (G.D.K.); and The Heart Hospital, London, United Kingdom (A.S., E.R.).
authors.forename: Mark E
authors.initials: ME
authors.lastname: Josephson
mesh_terms: D017115:Catheter Ablation / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology*
keywords: arrhythmias, cardiac; atrioventricular node; catheter ablation; tachycardia; tachycardia, atrioventricular nodal reentry