Catheter ablation of common atrioventricular nodal reentry tachycardia using the conventional method

Abstract

Background and objective: Atrioventricular nodal reentry tachycardia is the commonest type of supraventricular tachycardia referred to the electrophysiology laboratory. It constitutes about two thirds of the supraventricular tachycardia admitted to the emergency department. The mechanism of this tachycardia is reentry. This study aimed to evaluate the efficacy of radiofrequency ablation therapy in atrioventricular nodal reentry tachycardia as the first line treatment using the conventional method. Methods: The standard technique for the electrophysiological study done to induce tachycardia. Three or four catheters were used. Atrial or ventricular programmed stimulation used to induce the tachycardia. Differentiation of the atrioventricular nodal reentry from atrial tachycardia and atrioventricular tachycardia done by ventricular entrainment. The dry ablation catheter of 4 mm tip used to modify the slow pathway. The appearance of junctional rhythm was a sign of the effective application of the radiofrequency application. The success of ablation was indicated by a failure to induce the tachycardia with repeated programmed stimulation. Results: Seventy patients with atrioventricular nodal reentry tachycardia were selected from total supraventricular tachycardia cases of 106 patients referred to the catheter lab for radiofrequency ablation. In 85% of the cases atrial programmed stimulation were used to induce the tachycardia and ventricular programmed stimulation and in 15% of the cases. Acute success rate was seen in 68 patients (97%). Conclusion: Catheter radiofrequency ablation is becoming technically easy, safe, and reliable as first line treatment in the majority of patients with atrioventricular reentry tachycardia.