Author + information
- Received February 19, 1996
- Revision received May 2, 1996
- Accepted May 13, 1996
- Published online October 1, 1996.
- FRANK BOGUN1,
- BRADLEY KNIGHT,
- RAUL WEISS,
- MARWAN BAHU,
- RAJIVA GOYAL,
- MARK HARVEY,
- EMILE DAOUD,
- K.CHING MAN,
- S.ADAM STRICKBERGER and
- FRED MORADY*
- ↵*Address for correspondence: Dr. Fred Morady, University of Michigan Medical Center, 1500 East Medical Center Drive, B1F245, Ann Arbor, Michigan 48109-0022.
Objectives. The purpose of this study was to assess the clinical efficacy of radiofrequency ablation of the slow pathway in patients with documented but noninducible paroxysmal supraventricular tachycardia (PSVT) who have evidence of dual atrioventricular (AV) node pathways.
Background. Patients with a documented history of PSVT at times do not have inducible PSVT in the electrophysiology laboratory. Because dual AV node pathways serve as the substrate for AV node reentrant tachycardia (AVNRT), ablation of the slow pathway potentially may be useful in these patients.
Methods. The subjects in this prospective study were seven consecutive patients who underwent an electrophysiologic procedure because of documented PSVT and were found to have dual AV node physiology or inducible single AV node echo beats, but no inducible PSVT despite the administration of isoproterenol and atropine. Their mean (±SD) age was 33 ± 13 years, and they had been symptomatic for 12 ± 12 years. The frequency of the episodes of PSVT ranged from ≥1/day to 1/month. The rate of the documented episodes ranged from 170 to 260 beats/min, and discrete P waves were not apparent. Slow pathway ablation was performed with 9 ± 4 applications of radiofrequency energy using a combined anatomic and electrogram mapping approach.
Results. All evidence of dual AV node pathways was eliminated in six patients, and dual AV node physiology remained present in one patient. During a mean follow-up period of 15 ± 10 months (range 8 to 27), no patient had a recurrence of symptomatic tachycardia (success rate 95% confidence interval 65% to 100%).
Conclusions. Slow pathway ablation may be clinically useful in patients with documented but noninducible PSVT who have evidence of dual AV node pathways.
- Received February 19, 1996.
- Revision received May 2, 1996.
- Accepted May 13, 1996.
- THE AMERICAN COLLEGE OF CARDIOLOGY