Outcomes of catheter ablation for typical atrioventricular nodal reentrant tachycardia with low power energy

Autor: M Kim, J K Oh, Y H Yoon, H W Park, J H Roh, J H Lee
Rok vydání: 2022
Předmět:
Zdroj: European Heart Journal. 43
ISSN: 1522-9645
0195-668X
DOI: 10.1093/eurheartj/ehac544.467
Popis: Background Atrioventricular nodal reentrant tachycardia (AVNRT) is most common supraventricular tachycardia with acceptable outcome of catheter ablation. However, the serious complication of atrioventricular block (AVB) can occur and affects 0.2% to 2.3% of patients during or after procedures. Purpose We hypothesized that slow pathway ablation with 20 watt (W) energy would facilitate acceptable clinical outcomes and low procedure related AVB needed permanent pacemaker. Methods Prospective single center trial was performed. Slow pathway ablation was performed in 212 patients (mean age 56.5±18.4 years, 131 women) from January 2017 to May 2020. Twenty watt energy was delivered at the posterior region of the triangle of Koch until accelerated junctional rhythm was obtained. Results A total of 212 patients who underwent ablation for typical AVNRT were included. The acute success rate, the mean radiofrequency pulses applied per patient were 98.1% and 8.6±6.6, respectively. Transient AVB occurred in 5 patients (2.4%) and no permanent AVB requiring permanent pacemaker implantation occurred. Those who failed 20 W ablation were younger (success group age vs failed group age 58.2±17.4 vs 31.8±17.9 years, p=0.005) and had a faster heart rate just before slow pathway ablation (success group heart rate vs failed group heart rate 69.2±11.3 vs 76.8±5.6 bpm, p=0.59). The recurrence rate of 20 W ablation was 2.6% and the follow-up period was 18.3±4.1 months. Conclusion The low power approach for slow pathway ablation is highly effective and safe. If the heart rate just before ablation is lesser than 70 bpm, slow pathway ablation with 20 W energy could be considered. Further well-designed large-randomized studies are needed to define the role and effect of catheter ablation for typical AVNRT with low power energy. Funding Acknowledgement Type of funding sources: None.
Databáze: OpenAIRE
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