PMID: 8945080Nov 1, 1996Paper

Shortcut link between the fast and slow pathways and the mechanism of cure in atrioventricular nodal reentrant tachycardia by catheter ablation

Pacing and Clinical Electrophysiology : PACE
A NogamiYoshito Iesaka

Abstract

The mechanism of cure in AV nodal reentrant tachycardia (AVNRT) by catheter ablation has not been fully clarified. We hypothesized that disruption of a shortcut link between the fast and slow pathways is responsible for the elimination of tachycardia. AVNRT was eliminated in 20 patients by catheter ablation. In five patients (25%; group I) slow pathway conduction disappeared 1 week after ablation. In six patients (30%; group II), the effective refractory period of the slow pathway was prolonged by more than 50 ms (212 +/- 81 ms vs 340 +/- 81 ms; P < 0.05). In the remaining nine patients (45%; group III), there was no change in the refractory period (270 +/- 65 ms vs 273 +/- 74 ms), although tachycardia was not inducible. A shortcut link between the fast and slow pathways was examined by comparing the A-H intervals over the slow pathway during the tachycardia and during atrial pacing at the tachycardia cycle length. Prior to ablation, a shortcut link was assumed in 1 of group I patients, 2 of group II patients, and 8 of group III patients. Of the 9 patients in whom the slow pathway was not impaired after ablation (group III), 8 patients were found to have a shortcut link, while 8 of 11 patients with impairment of the slow pathwa...Continue Reading

Citations

Mar 21, 2000·Medical & Biological Engineering & Computing·A S al-Fahoum, I Howitt
Nov 14, 1997·Pacing and Clinical Electrophysiology : PACE·M HaïssaguerreJ Clémenty

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