Endocavitary ablation of nodal reentrant tachycardia
Jaïs, P.; Haïssaguerre, M.; Gencel, L.; Shah, D.C.; Le Métayer, P.; Clémenty, J.
Archives des Maladies du Coeur et des Vaisseaux 89(Special Issue 1): 83-87
1996
ISSN/ISBN: 0003-9683 PMID: 8734168 Document Number: 469224
Atrioventricular nodal reentrant tachycardias which, for a long time, could only be treated medically, may now benefit from catheter ablation. The rapid retrograde pathway was an effective initial target but carried a risk of complete atrioventricular block of about 10%. Nowadays, most operators deliver the radiofrequency energy (endocavitary cautery) to the slow nodal pathway. Different techniques of guidance (anatomical, electrophysiological, rapid potential, slow potential) are associated with high success rates: 90 to 100%. However, experimental studies suggest that the slow potentials arise from transitional cells within the tachycardia circuit (the anatomical substrate of the slow pathway). There is still a risk of complete atrioventricular block (1 to 5%) which should be clearly explained to patients referred for ablation of this constantly benign arrhythmia.