Comparative atrioventricular node properties after radiofrequency ablation and operative therapy of atrioventricular node reentry.

Published

Journal Article

The anatomical substrate for atrioventricular (AV) node reentry is unclear. To gain insights into the mechanism of cure of AV node reentry by nonpharmacological techniques, we compared AV node properties in 53 patients undergoing operative therapy (perinodal dissection) and 43 undergoing radiofrequency ablation (28 posterior approach, 15 anterior approach). Anterior radiofrequency ablation was associated with significant AH prolongation (62 +/- 18 msec vs 136 +/- 64 msec, P < 0.0001), loss of "fast" pathway physiology, and no change in the anterograde refractory period of the AV node (273 +/- 24 msec vs 268 +/- 28 msec, P = NS). Posterior radiofrequency ablation did not change the AH interval (67 +/- 17 msec vs 68 +/- 17 msec, P = NS), prolonged AV node effective refractory period (275 +/- 48 msec vs 320 +/- 55 msec, P < 0.0001), and was associated with loss of "slow pathway" physiology. Operative treatment prolonged the AH interval (66 +/- 18 msec vs 83 +/- 37 msec, P < 0.0001) and the AV node effective refractory period (264 +/- 52 msec vs 364 +/- 112 msec, P < 0.0001), and affected dual pathway physiology inconsistently. These data support the view that the "fast" and "slow" pathways are distinct perinodal entities that can be selectively ablated. The operative approach causes more diffuse and variable injury to the AV node region.

Full Text

Duke Authors

Cited Authors

  • Natale, A; Wathen, M; Wolfe, K; Yee, R; Guiraudon, GM; Klein, GJ

Published Date

  • May 1993

Published In

Volume / Issue

  • 16 / 5 Pt 1

Start / End Page

  • 971 - 977

PubMed ID

  • 7685896

Pubmed Central ID

  • 7685896

Electronic International Standard Serial Number (EISSN)

  • 1540-8159

International Standard Serial Number (ISSN)

  • 0147-8389

Digital Object Identifier (DOI)

  • 10.1111/j.1540-8159.1993.tb04570.x

Language

  • eng