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Electrophysiologic Characteristics and Radiofrequency Catheter Ablation in Atrioventricular Node Reentrant Tachycardia with Second‐Degree Atrioventricular Block
Author(s) -
LEE SHIHHUANG,
CHEN SHIHANN,
TAI CHINGTAI,
CHIANG CHERNEN,
WEN ZUCHI,
UENG KWOCHANG,
CHIOU CHUENWANG,
CHEN YIJBN,
YU WENCHUNG,
HUANG JINLONG,
CHENG JUNJACK,
CHANG MAUSONG
Publication year - 1997
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1997.tb00818.x
Subject(s) - medicine , tachycardia , cardiology , ablation , radiofrequency ablation , catheter ablation , atrioventricular node , refractory period , bundle of his , radiofrequency catheter ablation , effective refractory period , anesthesia , atrioventricular block , right bundle branch block , electrical conduction system of the heart , electrocardiography
Second‐Degree AV Block During AVNRT. Introduction : Detailed electrophysiologic study of AV nodal reentrant tachycardia (AVNRT) with 2:1 AV block has been limited. Methods and Results : Six hundred nine consecutive patients with AVNRT underwent electrophysiologic study and radiofrequency catheter ablation of the slow pathway. Twenty‐six patients with 2:1 AV block during AVNRT were designated as group I, und those without this particular finding were designated as group II. The major findings of the present study were: (1) group I patients had better anterograde and retrograde AV nodal function, shorter tachycardia cycle length (during tachycardia with 1:1 conduction) (307 ± 30 vs 360 ± 58 msec, P < 0.001), and higher incidence of transient bundle branch block during tachycardia (18/26 vs 43/609, P < 0.001) than group II patients: (2) 21 (80.8%) group I patients had alternans of AA intervals during AVNRT with 2:1 AV block. Longer AH intervals (264 ± 26 vs 253 ± 27 msec, P = 0.031) were associated with the blocked beats. However, similar HA intervals (51 ± 12 vs 50 ± 12 msec, P = 0.363) and similar HV intervals (53 ± 11 vs 52 ± 12, P = 0.834) were found in the blocked and conducted beats; (3) ventricular extrastimulation before or during the His‐bundle refractory period bundle could convert 2:1 AV block to 1:1 AV conduction. Conclusions : Fast reentrant circuit, rather than underlying impaired conduction of the distal AV node or infranodal area, might account for second‐degree AV block during AVNRT. Slow pathway ablation is safe and effective in patients who have AVNRT with 2:1 AV block.