Predictors of Acute and Long‐Term Success of Slow Pathway Ablation for Atrioventricular Nodal Reentrant Tachycardia: A Single Center Series of 1,419 Consecutive Patients

Feldman, Alexander; Voskoboinik, Aleksandr; Kumar, Saurabh; Spence, S.; Morton, Joseph B.; Kistler, Peter M.; Sparks, Paul B.; Vohra, Jitendra K.; Kalman, Jonathan M.

doi:10.1111/j.1540-8159.2011.03092.x

Cited by 70 publications

(64 citation statements)

References 22 publications

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“…Female sex has been associated with higher recurrence rates. 20 However, the recurrence rate of 3.9% in the current study was comparable with those of other reports, 2,4,8,16 and there was no statistically significant difference (P=0.945) in the proportions of women among patients who experienced recurrence (5 women among 7 patients, or 71%) and those who did not (122 women among 168 patients, or 72%).…”

Section: Discussionsupporting

confidence: 77%

Role of Isoproterenol in Predicting the Success of Catheter Ablation in Patients with Reproducibly Inducible Atrioventricular Nodal Reentrant Tachycardia

Heydari¹,

Tayyebi²,

Jami³

et al. 2014

Texas Heart Institute Journal

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Noninducibility of the arrhythmia is the widely accepted endpoint of successful ablation of atrioventricular nodal reentrant tachycardia (AVNRT).C atheter ablation of the slow pathway has been accepted as a highly effective treatment, with low recurrence rates, for patients with atrioventricular nodal reentrant tachycardia (AVNRT).1 Complete elimination of the slow pathway is not necessary for long-term symptomatic relief of the arrhythmia; the most widely accepted endpoint for acute success of the procedure is noninducibility of the arrhythmia. 1,2Routinely after slow-pathway ablation, attempts at reinduction of arrhythmia are performed, with or without isoproterenol or other provocative medications. Some physicians use isoproterenol after ablation regardless of its use before ablation (strategy 1), [3][4][5][6][7] whereas others use isoproterenol after ablation of AVNRT only when it had been necessary for arrhythmia induction before ablation (strategy 2). [8][9][10][11][12] However, the published data available for the comparison of these 2 strategies are inadequate. 13,14 In any event, the effectiveness of arrhythmia reproducibility in evaluating the success of AVNRT ablation has not been well defined: AVNRT inducibility is not reproducible in more than one third of cases, 15 and that failure of inducibility after ablation might sometimes indicate the absence of reproducibility, rather than the success of ablation.To avoid the confounding effect of nonreproducibility, we designed this study to investigate whether the post-ablation administration of isoproterenol for reinduction of AVNRT (in patients in whom the original arrhythmia had been reproducibly inducible without the use of any provocative agent) has any effect on the long-term recurrence rate of the arrhythmia. In both strategies stated above, isoproterenolwhen necessary for arrhythmia induction before ablation-is also used to evaluate the inducibility of AVNRT after ablation. Therefore, we did not include in our study any patients who needed isoproterenol for initial induction of AVNRT.

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Section: Discussionsupporting

confidence: 77%

Role of Isoproterenol in Predicting the Success of Catheter Ablation in Patients with Reproducibly Inducible Atrioventricular Nodal Reentrant Tachycardia

Heydari¹,

Tayyebi²,

Jami³

et al. 2014

Texas Heart Institute Journal

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“…De Sisti et al [12] in a large series of patients reported that slow pathway complete suppression relates to improved outcome, and a single nodal echo beat or residual AH jump are associated with a slightly higher incidence of recurrence, and the same results were reported by Bastani et al [29]. Feldman et al [30] reported that a single AV nodal echo beat did not predict AVNRT recurrence, but a large echo window is, indeed, associated with higher risk of recurrence.…”

Section: Residual Slow Pathway Conductionsupporting

confidence: 64%

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Matta

Anselmino

Scaglione

et al. 2016

J Interv Card Electrophysiol

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Purpose. Catheter ablation of the slow pathway is the most effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). Cryoenergy, compared to radiofrequency, relates to lower heart block risk, but higher incidence of AVNRT recurrences. The aim of this study is to confirm safety and efficacy of AVNRT cryoablation and to identify predictors of long-term recurrences. Conclusions. AVNRT cryoablation is safe and effective. Long-term recurrence rate was 11.7%. An ablation approach directed to the complete elimination of dual AV node physiology, along with assessment of tissue's cooling dynamics, hold the potential to improve long-term AVNRT cryoablation efficacy. Methods andAbstract word count: 244 2

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“…The presence of atypical AVNRT has been reported to be a predictor of procedural failure in a large study of AVNRT ablation in an adult population with normal anatomy (hazard ratio, 3.1). 20 It is reasonable to conclude that the combination of complex CHD with atypical AVNRT, especially with multiple slow pathways, increases the risk of procedural failure. AVNRT Ablation in Congenital Heart Disease…”

Section: Atypical Avnrt: a Risk Factor For Failure?mentioning

confidence: 99%

Atrioventricular Nodal Reentrant Tachycardia in Patients With Congenital Heart Disease

Papagiannis¹,

Beissel²,

Krause³

et al. 2017

Circ: Arrhythmia and Electrophysiology

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Background-The relationship of atrioventricular nodal reentrant tachycardia to congenital heart disease (CHD) and the outcome of catheter ablation in this population have not been studied adequately. Methods and Results-A multicenter retrospective study was performed on patients with CHD who had atrioventricular nodal reentrant tachycardia and were treated with catheter ablation. There were 109 patients (61 women), aged 22.1±13.4 years. The majority, 86 of 109 (79%), had CHD resulting in right heart pressure or volume overload. Patients were divided into 2 groups: group A (n=51) with complex CHD and group B (n=58) with simple CHD. There were no significant differences between groups in patients' growth parameters, use of 3-dimensional imaging, and type of ablation (radiofrequency versus cryoablation

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Predictors of Acute and Long‐Term Success of Slow Pathway Ablation for Atrioventricular Nodal Reentrant Tachycardia: A Single Center Series of 1,419 Consecutive Patients

Cited by 70 publications

References 22 publications

Role of Isoproterenol in Predicting the Success of Catheter Ablation in Patients with Reproducibly Inducible Atrioventricular Nodal Reentrant Tachycardia

Role of Isoproterenol in Predicting the Success of Catheter Ablation in Patients with Reproducibly Inducible Atrioventricular Nodal Reentrant Tachycardia

Cooling dynamics: a new predictor of long-term efficacy of atrioventricular nodal reentrant tachycardia cryoablation

Atrioventricular Nodal Reentrant Tachycardia in Patients With Congenital Heart Disease

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