Contribution of the electrophysiological and anatomical analysis of the atypical atrioventricular nodal tachycardia circuit.

Abstract:

OBJECTIVES:To analyze retrograde conduction during junctional ectopic tachycardia (JET) episodes and investigate the existence of a relationship between the presence of a retrograde block and the risk of atrioventricular block (AVB) development during radiofrequency ablation procedures in patients with nodal atrioventricular tachycardia (NAVT). METHODS:145 male and female patients aged 16-84 years, with NAVT who had undergone radiofrequency catheter ablation in the posteroseptal region of the right atrium were studied. Evaluation criteria were anatomical location and electrophysiological behavior of retrograde conduction during NAVT, in order to understand the nodal reentrant circuit (classifying the tachycardia as typical or atypical), and monitoring of retrograde conduction during JET episodes for risk-predicting AVB events. RESULTS:Of the 145 patients studied, 132 (91%) met electrophysiological and anatomical criteria of the typical form of NAVT, and 13 (9%) of atypical form. During the ablation, 5.3% with the typical form and 30.8% of the atypical form presented risk events for AVB. After the ablation, complications were a total AVB episode in one patient and a first-degree AVB episode in another in the typical group, and one first-degree AVB in the atypical group. All three episodes were preceded by risk events and resulted in permanent nodal injury. CONCLUSION:Patients with atypical NAVT presented higher percentages of risk events for atrioventricular block than did patients with the typical form (p=0.021).A careful observation of retrograde conduction during JET episodes is vital in order to avoid permanent damage in AV nodal conduction, such as TAVB, after the ablation procedure.

journal_name

Arq Bras Cardiol

authors

Silva MS,Sá RL,Fagundes ML,Cruz Filho FE,Arantes LB,Boghossian S,de Almeida AM,Fagundes RL,Romeo Filho LJ

doi

10.1590/s0066-782x2007000200003

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

144-51

issue

2

eissn

0066-782X

issn

1678-4170

pii

S0066-782X2007000200003

journal_volume

88

pub_type

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