Multicenter Outcomes of Catheter Ablation for Atrioventricular Reciprocating Tachycardia Mediated by Twin Atrioventricular Nodes.
JACC Clin Electrophysiol
; 8(3): 322-330, 2022 03.
Article
em En
| MEDLINE
| ID: mdl-34600852
ABSTRACT
OBJECTIVES:
This study sought to describe the electrophysiologic properties and catheter ablation outcomes for atrioventricular reciprocating tacchycardia via twin atrioventricular nodes (T-AVRT).BACKGROUND:
Although catheter ablation for T-AVRT is an established entity, there are few data on the electrophysiological properties and outcomes of this procedure.METHODS:
An international, multicenter study was conducted to collect retrospective procedural and outcomes data for catheter ablation of T-AVRT.RESULTS:
Fifty-nine patients with T-AVRT were identified (median age at procedure, 8 years [interquartile range 4.4-17.0 years]; 49% male). Of these, 55 (93%) were diagnosed with heterotaxy syndrome (right atrial isomerism in 39, left atrial isomerism in 8, and indeterminate in 8). Twenty-three (39%) had undergone Fontan operation (12 extracardiac, 11 lateral tunnel). After the Fontan operation, atrial access was conduit or baffle puncture in 15 (65%), fenestration in 5 (22%), and retrograde in 3 (13%). Acute success was achieved in 43 (91%) of 47 attempts (targeting an anterior node in 23 and posterior node in 24). There was no high-grade AV block or change in QRS duration. Over a median of 3.8 years, there were 3 recurrences. Of 7 patients with failed index procedure or recurrent T-AVRT, 6 (86%) were associated with anatomical hurdles such as prior Fontan or catheter course through an interrupted inferior vena cava-to-azygous vein continuation (P = 0.11).CONCLUSIONS:
T-AVRT can be targeted successfully with low risk for recurrence. Complications were rare in this population. Anatomical challenges were common among patients with reduced short and long-term efficacy, representing opportunities for improvement in procedural timing and planning.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ablação por Cateter
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Técnica de Fontan
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Taquicardia Reciprocante
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Cardiomiopatias
Tipo de estudo:
Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
Idioma:
En
Revista:
JACC Clin Electrophysiol
Ano de publicação:
2022
Tipo de documento:
Article