Arrhythmia recurrences are rare when the site of radiofrequency ablation of the slow pathway is medial or anterior to the coronary sinus os

The site of successful ablation of the slow atrioventricular (AV) nodal pathway may be located in the posteroseptal or midseptal area. We have previously shown that the site of successful radiofrequency (RF) ablation of the slow pathway, rather than residual slow pathway conduction correlates with AV nodal re-entrant tachycardia (AVNRT) recurrences, with more recurrences noted in inferoposterior (to the coronary sinus os) locations. Accordingly, we have since modified our approach, and in a consecutive series of 105 patients we have performed slow pathway RF ablation exclusively at medial or anterior locations, with the objective of prospectively examining the recurrence rate of AVNRT incurred with this approach.