Radiofrequency Ablation in Noninducible Supraventricular Tachycardia

Abstract

To evaluate the efficacy and safety of slow pathway radiofrequency ablation (RFA) in patients with clinically documented but noninducible paroxysmal supraventricular tachycardia (PSVT) and dual AV nodal physiology. We studied 8 out of 142 patients referred for PSVT RFA. They had documented but noninducible PSVT, corresponding to an AV nodal reentrant tachycardia (AVNRT) and dual AV nodal physiology (evidenced by AH jump ≥ 50 msec and one or more atrial echo beats) during the electrophysiological study. The presence of an accessory pathway was excluded. There were six women, mean age of 53±14 years. RFA was performed via anatomic approach (targeting the inferoposterior region of the triangle of Koch) and mapping of the slow pathway potential. A mean of 4 ± 2 pulses were delivered, at a mean power of 34 ± 8 W. The acute outcome was 100% successful, without any echo beats or AH jumps. No arrhythmia occurred during a mean follow-up period of 19 ±3 months. Slow pathway ablation might be beneficial in patients with documented but noninducible PSVT and dual AV nodal physiology.