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Ablation for AVNRT

Milos Kesek, Daniel Lindmark, Amir Rashid, Steen M Jensen
BACKGROUND: Catheter ablation of the slow pathway is standard treatment for atrioventricular nodal reentry tachycardia (AVNRT), with a well-described, low risk for periprocedural atrioventricular block. Less is known about the risk of pacemaker implantation late after ablation. OBJECTIVE: We aimed to quantify the risk of late pacemaker-implantation in a countrywide cohort undergoing first-time ablation for AVNRT. METHODS: All patients undergoing first-time ablation for AVNRT in Sweden from 2004-2014 were identified from the Swedish ablation registry and matched against the Swedish pacemaker registry...
February 28, 2019: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Hielko Miljoen, Joris Ector, Christophe Garweg, Johan Saenen, Wim Huybrechts, Andrea Sarkozy, Rik Willems, Hein Heidbuchel
AIMS: Prolonged participation in exercise results in structural and electrical cardiac remodelling. The development of an athlete's heart is recognized as a risk factor for atrial arrhythmias. This study aims to evaluate the impact of athlete heart remodelling on the presentation of atrioventricular nodal re-entrant tachycardia (AVNRT). METHODS AND RESULTS: A retrospective analysis of an ablation database selecting all patients with an electrophysiologically confirmed diagnosis of AVNRT...
February 14, 2019: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Demosthenes G Katritsis, Theodoros Zografos, Konstantinos C Siontis, George Giannopoulos, Rahul G Muthalaly, Qiang Liu, Rakesh Latchamsetty, Zoltán Varga, Spyridon Deftereos, Charles Swerdlow, David J Callans, John M Miller, Fred Morady, Roy M John, William G Stevenson
OBJECTIVES: This study sought to investigate markers of success following slow pathway ablation for atrioventricular nodal re-entrant tachycardia (AVNRT). BACKGROUND: Published data are conflicting. METHODS: The authors studied 1,007 patients with typical AVNRT and 77 patients with atypical AVNRT. RESULTS: Following ablation, tachycardia was rendered not inducible in all patients. One case of transient (0.09%) and 1 of permanent (0...
January 2019: JACC. Clinical Electrophysiology
Gong-Bu Zhou, Jian Ma, Jin-Lin Zhang, Xiao-Gang Guo, Jian-du Yang, Shu-Wang Liu, Fei-Fan Ouyang
BACKGROUND: Dextrocardia with situs inversus is a rare cardiac positional anomaly. Catheter ablation procedures performed in this set of patients are not sufficiently reported. METHODS: A total of 10 patients with dextrocardia and situs inversus, who received catheter ablation for supraventricular tachycardia (SVT), were included from a cohort of over 20,000 cases of catheter ablation for SVT in 3 centers from 2005 to 2016. All patients underwent electrophysiologic study and catheter ablation of SVT...
January 19, 2019: Journal of Cardiovascular Electrophysiology
F Plank, B Stowasser, D Till, W Schgör, W Dichtl, F Hintringer, G Weiss, M Stühlinger
BACKGROUND: Exposure to high doses of radiation during cardiac interventional procedures is associated with increased rates of cataract and cancer in patients and staff members. Thus, reduction of radiation is recommended by international medical societies. The aim of this study was to evaluate, if the lowest reasonable fluoroscopic acquisition setting for electrophysiological procedures using a novel X-ray detector operated at a minimum detector entrance dose per fluoroscopy pulse is feasible and safe...
January 2019: European Journal of Radiology
E A Kringeland, I Deisenhofer, G Hessling, P Schuster
OBJECTIVES: Catheter ablation is regarded as first-line therapy for symptomatic atrioventricular nodal reentry tachycardia (AVNRT). Ablation induces intended myocardial damage and the extent of myocardial damage may differ between ablation methods. The objective of this MAGMA AVNRT(NCT00875914) substudy was to compare high-sensitive cardiac troponin T (hs-cTnT) levels as a surrogate marker for myocardial damage after manually guided (MAN) AVNRT ablation versus AVNRT ablation using remote magnetic navigation (RMN)...
December 20, 2018: Scandinavian Cardiovascular Journal: SCJ
Tomonori Watanabe, Hitoshi Hachiya, Shigeki Kusa, Takatsugu Kajiyama, Kazuya Yamao, Shinsuke Miyazaki, Miyako Igarashi, Hiroaki Nakamura, Yasushi Imai, Kazuomi Kario, Yoshito Iesaka
PURPOSE: Low dose-adenosine triphosphate (LD-ATP) is useful for diagnosing ATP-sensitive atrial tachycardia. However, the clinical implications of the sensitivity of LD-ATP in atrioventricular nodal reentrant tachycardia (AVNRT) still remain unknown. This study aimed to evaluate the mechanism of LD-ATP sensitivity in slow-fast AVNRT. METHODS: We estimated the sensitivity of LD-ATP in slow-fast AVNRT by a 2-4 mg ATP intravenous injection during the tachycardia. We evaluated the atrial-His interval, tachycardia termination mode, prevalence of a lower common pathway (LCP), and successful ablation site in slow-fast AVNRT with LD-ATP sensitivity...
December 19, 2018: Pacing and Clinical Electrophysiology: PACE
Daniel W Kaiser, Javed M Nasir, L Bing Liem, Chad Brodt, Kara S Motonaga, Scott R Ceresnak, Mintu P Turakhia, Anne M Dubin
BACKGROUND: The postpacing interval (PPI) minus the tachycardia cycle length (TCL) is frequently used to investigate tachycardias. However, a variety of issues (eg, failure to entrain, decremental conduction, and oscillating TCLs) can make interpretation of the PPI-TCL challenging. OBJECTIVE: The purpose of this study was to investigate a novel maneuver to confirm the PPI-TCL value without using either the ventricular PPI or the TCL interval and to assess the ability of this maneuver to identify decremental conduction and differentiate supraventricular tachycardias...
November 20, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Christophe Garweg, Stijn De Buck, Bert Vandenberk, Rik Willems, Joris Ector
AIM: 3D Rotational angiography (3DRA) allows for detailed reconstruction of atrial anatomy and is often used to facilitate pulmonary vein isolation. This study aimed to reappraise the anatomy of the right atrium (RA) using 3DRA, specifically looking at Koch's triangle and the cavotricuspid isthmus (CTI) in atrio-ventricular reentrant tachycardia (AVNRT) and atrial flutter (AFl) ablation. METHODS AND RESULTS: 3DRA was performed in 97 patients: AVNRT = 51 and AFl = 46...
October 2018: Scandinavian Cardiovascular Journal: SCJ
Philippe-Richard Domeyer, Smaragda Ch Giannakidou, Panagiota Kyriakou, Vasiliki Katsari, Antonios P Antoniadis, Ioannis K Lagos, Nikolaos Fragakis, Agoritsa Varaklioti, Vassilios P Vassilikos
Objective: This study aims to (i) translate, culturally adapt, and preliminarily validate the arrhythmia-specific Umea22 (U22) questionnaire and (ii) assess the impact of radiofrequency (RF) ablation and medical treatment on the quality of life of patients with supraventricular tachycardias (SVTs). Methods: A total of 140 patients with atrioventricular nodal re-entry tachycardia (AVNRT) and atrioventricular re-entry tachycardia (AVRT) were enrolled in the study...
2018: BioMed Research International
Wei Li, Jian Sun, Ying Yu, Zhi-Quan Wang, Peng-Pai Zhang, Kai Guo, Man-Tian Chen, Yi-Gang Li
BACKGROUND: Post cardiac injury syndrome (PCIS) is a troublesome but not uncommon complication following catheter ablation of arrhythmias. We aimed to study the clinical features of ablation-associated PCIS. METHODS: For this purpose, we conducted a computerised literature search that identified 19 published cases, and we additionally included another 2 new cases from our centres. Twenty-one cases of PCIS following ablation were analysed. RESULTS: Among the 21 cases, PCIS most commonly occurred after atrial flutter/fibrillation (AFL/AF) ablation (71...
October 7, 2018: Heart, Lung & Circulation
H Jiang, X M Li, M T Li, X C Zheng, H J Liu, Y Zhang, H Y Ge
Objective: To investigate the clinical features and evaluate the efficacy of radiofrequency catheter ablation (RFCA) guided by 3D electronic-anatomy mapping system (CARTO3 System) in children with atrioventricular nodal reentrant tachycardia (AVNRT). Methods: This was a retrospective case-controlled study. Data were collected from 95 children with AVNRT who underwent RFCA using CARTO3 System in the first hospital of Tsinghua University from January 2014 to December 2017. The onset age, characteristic of electrophysiology and anatomy feature of Koch triangle were analyzed...
September 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Korbinian Lackermair, Stefanie Kellner, Antonia Kellnar, Lisa M Riesinger, Reza Wakili, Moritz F Sinner, Konstantinos D Rizas, Stephanie Fichtner, Heidi L Estner
BACKGROUND: A novel, automatically annotating ultra-high density mapping system (Rhythmia©, Boston Scientific) collects a high number and quality of electrograms (EGMs). So far, data on general use in the electrophysiological laboratory are sparse. METHODS: We retrospectively analyzed all our ablations using Rhythmia and recorded patient clinical data, procedural parameters, and mapping parameters including the count of EGMs, mapping time, and mapping volume. Where appropriate, procedural parameters were compared over time to assess a learning curve...
December 1, 2018: International Journal of Cardiology
Roy Chung, Oussama Wazni, Thomas Dresing, Mina Chung, Walid Saliba, Bruce Lindsay, Patrick Tchou
BACKGROUND: Narrow QRS tachycardia or premature beat with bystander atrial activation or ventricular-atrial dissociation is an unusual arrhythmia that can present diagnostic and therapeutic challenges. When ventricular-atrial conduction is robust, these arrhythmias can be difficult to distinguish from atrioventricular nodal reentry. OBJECTIVE: The purpose of this study was to describe the electrophysiology characteristics, diagnostic maneuvers, and treatment of these types of arrhythmias in a series of 7 cases...
August 10, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Sevket Balli, Mehmet Kucuk, Mustafa Orhan Bulut, Ilker Kemal Yucel, Ahmet Celebi
Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is one of the most common supraventricular tachycardia substrates. The aim of this study was to demonstrate the excellent outcomes of cryoablation without fluoroscopy in pediatric patients with AVNRT. Methods: From September 2015 to October 2016, a transcatheter cryoablation procedure was performed in 109 patients using the EnSite® system. After electrophysiologic studies, a cryoablation catheter was advanced for the purpose of ablation of the slow pathway...
July 2018: Acta Cardiologica Sinica
Amanda M Marshall, Christopher C Erickson, David A Danford, John D Kugler, Vincent C Thomas
PURPOSE: Patients with atrioventricular nodal reentry tachycardia (AVNRT) often are managed successfully by ablation of the slow pathway with success rates reported as high as 99%. Low voltage bridges (LVBs) have been demonstrated to be helpful in guiding AVNRT ablation. Patients may present to the electrophysiology lab without evidence of inducible arrhythmia. In these scenarios, the demonstration of LVBs may be diagnostic and guide catheter ablation treatment. The purpose of our study was to prospectively investigate the specificity of LVBs as a diagnostic marker of AVNRT...
July 21, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Jae-Sun Uhm, Jong-Il Choi, Yong Soo Baek, Hee Tae Yu, Pil-Sung Yang, Yun Gi Kim, Suk-Kyu Oh, Hee-Soon Park, Kwang No Lee, Tae-Hoon Kim, Jaemin Shim, Boyoung Joung, Hui-Nam Pak, Moon-Hyoung Lee, Young-Hoon Kim
BACKGROUND: The electrophysiological features and roles of persistent left superior vena cava (PLSVC) in supraventricular tachycardia (SVT) are not known. OBJECTIVE: The purpose of this study was to elucidate the electrophysiological features and roles of PLSVC in patients with SVT. METHODS: We included 37 patients with PLSVC (mean age 43.5 ± 17.1 years; 35.1% men) and 510 patients without PLSVC (mean age 43.9 ± 18.8 years; 48.2% men) who underwent an electrophysiology study for SVT...
June 25, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Henrike Siebels, Christian Sohns, Jan-Hendrik Nürnberg, Jürgen Siebels, Klaus Langes, Joachim Hebe
PURPOSE: Radiofrequency current energy (RFC) ablation is still considered as the gold standard for atrioventricular nodal reentrant tachycardia (AVNRT). Success-rates for AVNRT ablation vary irrespective of the ablation technology and strategy. This study aimed to access safety, efficacy, and long-term outcome of RFC catheter ablation for the treatment of AVNRT in children and adolescents aged < 19 years with special focus on modulation versus ablation of the AV nodal slow pathway (SP)...
May 15, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Chunli Li, Libo Jia, Zhenzhou Wang, Ling Niu, Xinjiang An
The present study investigated the therapeutic effect of radiofrequency ablation on children with supraventricular tachycardia (SVT), and explored the risk factors for postoperative recurrence. A total of 312 patients with pediatric SVT were selected in the Affiliated Children's Hospital of Xuzhou Medical University from April, 2011 to March, 2017. All the patients were subjected to radiofrequency ablation, and clinical data were retrospectively analyzed. Tilt table test was performed before and after treatment, and heart rate, systolic and diastolic blood pressure before and after treatment were compared...
May 2018: Experimental and Therapeutic Medicine
Laurent M Haegeli, Linda Stutz, Mohammed Mohsen, Thomas Wolber, Corinna Brunckhorst, Chol-Jun On, Firat Duru
BACKGROUND: Awareness of risks associated with radiation exposure to patients and medical staff has significantly increased. It has been reported before that the use of advanced three-dimensional electro-anatomical mapping (EAM) system significantly reduces fluoroscopy time, however this study aimed for zero or near zero fluoroscopy ablation to assess its feasibility and safety in ablation of atrial fibrillation (AF) and other tachyarrhythmias in a "real world" experience of a single tertiary care center...
April 3, 2018: Cardiology Journal
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