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Atrioventricular Nodal Reentrant Tachycardia with Multiple Discontinuities in the Atrioventricular Node Conduction Curve: Immediate Success Rates of Radiofrequency Ablation and Long-Term Clinical Follow-up Results as Compared to Patients with Single or No AH-Jumps

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Abstract

Background: Some patients with atrioventricular nodal reentrant tachycardia (AVNRT) demonstrate multiple discontinuities (AH jump) in their antegrade AV node conduction curves. We evaluated and compared the immediate success rates, procedure-related complications, long-term clinical follow-up results and recurrence rates after slow pathway ablation in patients with multiple versus single or no AH jumps.

Methods: The study group consists of 278 consecutive patients (mean age 36.6 ± 15.7) who underwent ablation for typical AVNRT, divided into three categories according to the number of AH jumps (≥50 ms) before ablation: Group-1 consisted of 63 patients (23%) with continuous AV node function curves; Group-2 of 183 patients (66%) with a single jump and Group-3 of 32 (12%) patients showing more than one AH jumps.

Results: Age was significantly higher in Group-3 as compared to Group-1 (43 ± 18 years vs. 34 ± 16 years, p = 0.020). The electrophysiological features of AVNRT did not differ among groups. Before ablation, the maximum AH interval was significantly longer in Group-3 as compared to Groups-1 and -2 (p < 0.001 for both). AV node antegrade ERP was significantly shorter in Group-3 than in Group-2, both before and after ablation (p < 0.050 for both). AV node Wenckebach cycle length (WCL) was shorter in Group-3 as compared to both Groups-1 and -2, before and after ablation (p < 0.050 for all). AV node WCL was prolonged significantly in all groups after ablation (p < 0.001 for all). Residual dual pathways were present in 37 of 278 patients (13%) after ablation and were significantly more frequent in Group-3 than Group-2 (31% vs. 15%, p = 0.023).

Conclusions: Patients with multiple AH jumps are older and more often have residual dual atrioventricular nodal pathway physiology after successful ablation but these features do not affect the immediate and long-term success rates of slow pathway ablation as compared to patients with single or no AH jumps.

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Authors and Affiliations

  1. Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey

    Sedat Kose, Basri Amasyali, Ayhan Kilic, Ilknur Can, Hurkan Kursaklioglu, Turgay Celik & Ersoy Isik

  2. Department of Cardiology, Hacettepe University Faculty of Medicine, Ankara, Turkey

    Kudret Aytemir

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  1. Sedat Kose
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  2. Basri Amasyali
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Kose, S., Amasyali, B., Aytemir, K. et al. Atrioventricular Nodal Reentrant Tachycardia with Multiple Discontinuities in the Atrioventricular Node Conduction Curve: Immediate Success Rates of Radiofrequency Ablation and Long-Term Clinical Follow-up Results as Compared to Patients with Single or No AH-Jumps. J Interv Card Electrophysiol 10, 249–254 (2004). https://doi.org/10.1023/B:JICE.0000026920.40169.9f

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  • DOI: https://doi.org/10.1023/B:JICE.0000026920.40169.9f

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