Apr 1, 1993

Radiofrequency catheter ablation for AV nodal reentry: a technique for rapid transection of the slow AV nodal pathway

Pacing and Clinical Electrophysiology : PACE
K P MoultonW T Woods

Abstract

Selective radiofrequency (RF) catheter ablation of the slow AV nodal pathway has shed new light on the anatomy and physiology of the atrioventricular junction. The recording of "slow pathway potentials" facilitates localization of the slow pathway and has led to a concept of multiple pathway components with atrial insertion sites covering a potentially broad region surrounding the coronary sinus os. The critical area for complete interruption of the slow pathway may be larger than lesion size produced by ablation at a single site, resulting in multiple RF applications with lengthy sessions and prolonged radiation exposure. Information from both old and recent literature suggests that the slow AV nodal pathway is represented by a group of fibers originating from the posteroinferior interatrial septum and coursing anterosuperiorly near the tricuspid annulus before converging upon the compact AV node. Based on this anatomical arrangement, the present study was conducted to evaluate a technique designed to transect the slow pathway by producing a linear RF lesion perpendicular to the orientation of the slow pathway within the mid-portion of Koch's triangle. Using this technique, 30 of 30 patients with common AV nodal reentry were r...Continue Reading

Mentioned in this Paper

Establishment and Maintenance of Localization
Biochemical Pathway
Paroxysmal Reciprocal Tachycardia
Coronary Sinus Structure
Recurrent Malignant Neoplasm
Atrial Tachycardia
Fluoroscopy
Perforation of Nasal Septum
2D Echocardiography
Recurrence (Disease Attribute)

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