Catheter-induced mechanical trauma to fast and slow pathways during radiofrequency ablation of atrioventricular nodal reentry tachycardia: incidence, predictors, and clinical implications.
Pacing Clin Electrophysiol
; 30(10): 1233-41, 2007 Oct.
Article
in En
| MEDLINE
| ID: mdl-17897126
ABSTRACT
BACKGROUND:
Data on the incidence and significance of catheter-induced trauma to fast and slow pathways are scarce.OBJECTIVES:
To evaluate the incidence, predictors, and clinical implications of inadvertent catheter-induced mechanical trauma to fast and slow pathways during radiofrequency ablation (RFA) of atrioventricular nodal reentry tachycardia (AVNRT).METHODS:
A total of 901 consecutive patients (aged 9-92 years old) with inducible sustained AVNRT underwent RFA of the slow pathway. All procedures were closely monitored for appearance of catheter-induced mechanical block of fast or slow pathways.RESULTS:
Catheter-induced mechanical trauma to fast and/or slow pathways was observed in 121 (13.4%) patients 86 (71%) patients had trauma of the fast pathway, three (2.4%) had trauma of the slow pathway, and 32 (26.4%) had trauma of both pathways. Mechanical trauma lasted <1 minute in 87 (72%) patients, 1-30 minutes in 23 (19%) and >30 minutes in 11 (9%). A significantly increased procedure discontinuation rate was observed in patients with mechanical trauma as compared to those with no trauma (P < 0.0001). Young patient age (<35) was a strong predictor for the occurrence of mechanical trauma to AV nodal pathways. No significant difference between the trauma and non-trauma groups was found in respect to the number of catheters used during the procedure, the incidence of AV block, and the need for permanent pacemaker implantation.CONCLUSIONS:
Mechanical trauma to fast and slow pathways during ablation of AVNRT is more common than previously recognized, occurring especially in patients aged <35 years.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tachycardia, Atrioventricular Nodal Reentry
/
Catheter Ablation
/
Heart Conduction System
Type of study:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Pacing Clin Electrophysiol
Year:
2007
Document type:
Article
Affiliation country:
Israel