The Study Of The Endpoints Of Slow Atrioventricular Nodal Pathway Ablation In Patients With Atrioventricular Nodal Reentrant Tachycardia

Objective To explore the endpoints of slow atrioventricular(AV) nodal pathway ablation in patients with atrioventricular nodal reentrant tachycardia and ideal method. Methods Slow AV nodal pathway ablation was performed in 163 patients with AV nodal reentrant tachycardia(AVNRT) in order to evaluate the effect of endpoint type A(no slow pathway conduction and no induciable AVNRT),B(residual slow pathway conduction and 1 to 2 AV nodal echo but no induciable AVNRT) on coduction and their relation with AVNRT recurrence and AVblock occur rate and methods. Result Ablation was successful in all patients. Of 163 patients, 108 (66.3%) and 55 (33.7%) patients reached endpoint type A and B respectively after procedure. 163 patients were followed up 1~45 months and AVNRT recurrence were 1 (0.9%) in patients with type A and 3 (5.5%) in patients with type B , 4 patients required second successful ablation . Of 6 patients, temporary atrioventricular block occurred in 4 patients and delay AV block occurred in 2 patients. Using median approach(M) for selective ablation of the slow AV nodal pathway was significantly shorter than lower approach(L) in the procedure time , the number of energy application and the fluoroscopic operation time. The change of parametes was significant in patients with recurrence in M(1%) and L(4.6%) , and not significant with complication . There was no significant between type A and type B in occurrence of AVB , and significant between group whose atrioventricular nodal jump point exceed 400ms and under 400ms.Conclusion Slow atrioventricular nodal pathway ablation in patients with atriowentricular nodal reentrant tachycardia is effective method. Slow pathway conduction which was not completely blocked is associated with recurrent, however completely blocked slow pathway coduction can obviously lower recurrence and no increase AV block occurrence . Ablation position, the faster rate of junctional ectopy and time of atrioventricular nodal jump value involved in AV block occurrence . The median approach is a safe effective and ideal method for treating AVNRT .