PMID: 11345379May 10, 2001Paper

Optimized mapping of slow pathway ablation guided by subthreshold stimulation: a randomized prospective study in patients with recurrent atrioventricular nodal re-entrant tachycardia

Journal of the American College of Cardiology
S WillemsT Meinertz

Abstract

This randomized prospective study sought to assess the value of slow pathway (SP) mapping and ablation guided by subthreshold stimulation (STS) in comparison with a strategy based on conventional criteria. Previous studies have demonstrated that STS can be used as a highly specific and sensitive marker for successful SP ablation in the setting of atrioventricular nodal re-entrant tachycardia (AVNRT). Nonetheless, thus far this mapping strategy has not been investigated in contrast with the conventional approach. One hundred patients with sustained AVNRT were included. Fifty patients (group A) were randomly assigned to endocardial mapping and SP ablation using currently established criteria. In the other 50 patients (group B), SP ablation was guided by STS mapping. In group B patients, only radiofrequency current (RFC) was applied if additionally constant current STS (up to 5 mA) during AVNRT interrupted the tachycardia due to selective block within the SP. Termination of AVNRT without apparent capture was observed during STS in 47 of 50 group B patients (94%). In all cases, this effect was indicative for successful subsequent SP ablation. The mean number of RFC pulses required for successful SP ablation was significantly lower ...Continue Reading

References

Oct 1, 1992·Journal of the American College of Cardiology·M Fromer, M Shenasa
May 1, 1967·Circulation·C Fisch, K Greenspan

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Citations

Oct 1, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Thomas A DewlandGregory M Marcus
Apr 27, 2005·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Paresh ShahDan Dan
Dec 23, 2017·Journal of the American Heart Association·Alban-Elouen BaruteauMaully J Shah
May 25, 2016·Circulation. Arrhythmia and Electrophysiology·Amit NoheriaChristopher J McLeod

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