Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compa...Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compared two methods (maximal AH interval during decremental atrial stimlation vs occurrence of AV nodal echos or dual AV nodal physiology (DAVNP): ≥50 msec increment in AH interval with a 10 msec decrement in A1A2) for the assessment of SP function immediately and 40 minutes after successful RF modification of SP. In 31 consecutive patients (age: 51±16 years, 18 women, 13 men) with typical AVNRT, SP modification was performed using a combined anatomic and electrogram guided approach. Immediately after successful SP modification, AV nodal function was assessed. This was repeated 40 minutes later. RF modification of SP was successful in all 31 patients. There was no recurrance during a 5±3 month follow up period. There was no significant difference between the electrophysiological parameters immediately and University of Frankfurt, Germany (Li YG, Bogun F, Grnefeld G, Hohnloser SH and Goethe JW)40 min after successful SP modification. There was evidence of SP function in 14 patients (6 with DAVNP+AV nodal echoes, 8 with either DAVNP or AV nodal echos) immehiately after SP modification. These patients could be differentiated from the patients without remaining SP function by maximal AH interval (298±102 msec vs 198±72 msec, P=0.004). 40 minutes after the suucessful SP modification, 11 patients displayed SP function (4 patients with DAVNP+AV nodal echos, 7 patients with either DAVNP or AV nodal echos). These patients could also be differentiated from the remaining patients with the use of the maximal AH interval (294±89 msec vs 189±50 msec, P<0.001).[BHDFG3,WK9ZQ,WK6,WK10*2,WK5W]Befroe SP modificationImmediately after RF40 min after RF[BHDZG1*2,WK9ZQ,WK6,WK10*2,WK5W]AVNERP (msec)258±44310±116316±114AVBCL (msec)330±55384±113376±110VABCL (msec)306±67306± 66311±54Max AH (msec)337±96247±100233±86 Conclusion SP function assessed immediately and 40 minutes after a successful SP modification remains stable. SP function can be assessed reliable by maximal AH interval during decremental atrial stimulation.展开更多
文摘Background Persistence of slow pathway (SP) function after SP modification is not uncommon after successful rediofrequency (RF) ablation of typical AV nodal reentry tachycardia (AVNRT). Methods and results We compared two methods (maximal AH interval during decremental atrial stimlation vs occurrence of AV nodal echos or dual AV nodal physiology (DAVNP): ≥50 msec increment in AH interval with a 10 msec decrement in A1A2) for the assessment of SP function immediately and 40 minutes after successful RF modification of SP. In 31 consecutive patients (age: 51±16 years, 18 women, 13 men) with typical AVNRT, SP modification was performed using a combined anatomic and electrogram guided approach. Immediately after successful SP modification, AV nodal function was assessed. This was repeated 40 minutes later. RF modification of SP was successful in all 31 patients. There was no recurrance during a 5±3 month follow up period. There was no significant difference between the electrophysiological parameters immediately and University of Frankfurt, Germany (Li YG, Bogun F, Grnefeld G, Hohnloser SH and Goethe JW)40 min after successful SP modification. There was evidence of SP function in 14 patients (6 with DAVNP+AV nodal echoes, 8 with either DAVNP or AV nodal echos) immehiately after SP modification. These patients could be differentiated from the patients without remaining SP function by maximal AH interval (298±102 msec vs 198±72 msec, P=0.004). 40 minutes after the suucessful SP modification, 11 patients displayed SP function (4 patients with DAVNP+AV nodal echos, 7 patients with either DAVNP or AV nodal echos). These patients could also be differentiated from the remaining patients with the use of the maximal AH interval (294±89 msec vs 189±50 msec, P<0.001).[BHDFG3,WK9ZQ,WK6,WK10*2,WK5W]Befroe SP modificationImmediately after RF40 min after RF[BHDZG1*2,WK9ZQ,WK6,WK10*2,WK5W]AVNERP (msec)258±44310±116316±114AVBCL (msec)330±55384±113376±110VABCL (msec)306±67306± 66311±54Max AH (msec)337±96247±100233±86 Conclusion SP function assessed immediately and 40 minutes after a successful SP modification remains stable. SP function can be assessed reliable by maximal AH interval during decremental atrial stimulation.
