Sub-threshold stimulation in variants of atrioventricular nodal re-entrant tachycardia: electrophysiological effects and impact for guidance of slow pathway ablation

European Heart Journal
Stephan WillemsThomas Meinertz

Abstract

Sub-threshold stimulation (STS) applied during atrioventricular nodal re-entrant tachycardia (AVNRT) of the common (slow-fast) type has been shown to effectively characterise target sites suitable for slow pathway (SP) ablation but has not been investigated in the setting of fast-slow and slow-slow variants. Seventeen consecutive patients (52+/-16 years, 12 female) with sustained uncommon type AVNRT (fast-slow: n = 13, slow-slow: n = 4) were investigated. Mapping of the SP was started postero-septally close to the coronary sinus ostium and continued toward mid-septal sites, if required. Target sites for STS were selected according to established criteria including the recording of the earliest retrograde atrial activation during AVNRT. Long duration (5 s) constant current STS during AVNRT variants was performed in a stepwise manner (max 5 mA) at each site eligible for SP ablation until termination or capture occurred. Radiofrequency current (RFC) was delivered following successful STS termination of tachycardia (65 degrees C, 60 s) and exclusion of catheter dislodgement. Uncommon AVNRT with a mean cycle length of 405+/-70 ms was induced without spontaneous termination in all patients. Interruption of AVNRT variants due to selec...Continue Reading

Citations

Apr 25, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Demosthenes G Katritsis, Mark E Josephson
Jun 11, 2005·Journal of Cardiovascular Electrophysiology·Thomas RostockStephan Willems
May 2, 2006·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Thomas Rostock, Stephan Willems

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