Cargando…

Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump

PURPOSE: A residual slow pathway after successful cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is correlated with a higher recurrence rate. We described determinants of recurrence in subjects with a residual jump. METHODS: We analyzed the data of subjects with acute successf...

Descripción completa

Detalles Bibliográficos
Autores principales: Tonet, Joelci, De Sisti, Antonio, Pardo Restrepo, Natalia, Raguin, Denis, Amara, Walid, Márquez, Manlio F., Aouate, Philip, Waintraub, Xavier, Touil, Faouzi, Hidden-Lucet, Francoise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435514/
https://www.ncbi.nlm.nih.gov/pubmed/22562357
http://dx.doi.org/10.1007/s10840-012-9680-7
_version_ 1782242534744915968
author Tonet, Joelci
De Sisti, Antonio
Pardo Restrepo, Natalia
Raguin, Denis
Amara, Walid
Márquez, Manlio F.
Aouate, Philip
Waintraub, Xavier
Touil, Faouzi
Hidden-Lucet, Francoise
author_facet Tonet, Joelci
De Sisti, Antonio
Pardo Restrepo, Natalia
Raguin, Denis
Amara, Walid
Márquez, Manlio F.
Aouate, Philip
Waintraub, Xavier
Touil, Faouzi
Hidden-Lucet, Francoise
author_sort Tonet, Joelci
collection PubMed
description PURPOSE: A residual slow pathway after successful cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is correlated with a higher recurrence rate. We described determinants of recurrence in subjects with a residual jump. METHODS: We analyzed the data of subjects with acute successful slow pathway cryoablation for AVNRT using a 6-mm-tip cryocatheter. Success was defined as AVNRT non-inducibility. Patients with no baseline elicitable jump, no inducible AVNRT, and transient first atrioventricular (AV) block at the last site were excluded. RESULTS: From 371 patients who underwent cryoablation from May 2002 to March 2011, 303 fulfilled the entry criteria (mean age, 41 ± 16; 222 women). Baseline AV nodal effective refractory period (ERP) was 272 ± 57 ms, postprocedural 331 ± 64 (P < 0.001), and the mean of the difference (Δ ERP) 60 ± 41. At the end of the procedure, 64 patients (21 %) had a residual jump, of whom 22 with a single echo. At 12 months follow-up, the actuarial recurrence-free rate was 70.3 % in patients with a residual jump and 86 % in those without (P = 0.01). In patients with a jump, only Δ AV nodal ERP was correlated with recurrence (37 ± 41 vs. 68 ± 47 ms; P < 0.04) while a single echo was not. The actuarial rate of recurrence was 60.8 % in patients with a Δ AV nodal ERP ≤ 30 ms and 18.8 % in those with a Δ AV nodal ERP >30 ms (P < 0.01). CONCLUSIONS: Suppression of slow pathway conduction is the optimal endpoint for AVNRT cryoablation. A residual jump can be tolerated if AV nodal ERP postcryoablation is prolonged >30 ms.
format Online
Article
Text
id pubmed-3435514
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-34355142012-09-07 Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump Tonet, Joelci De Sisti, Antonio Pardo Restrepo, Natalia Raguin, Denis Amara, Walid Márquez, Manlio F. Aouate, Philip Waintraub, Xavier Touil, Faouzi Hidden-Lucet, Francoise J Interv Card Electrophysiol Article PURPOSE: A residual slow pathway after successful cryoablation for atrioventricular nodal reentrant tachycardia (AVNRT) is correlated with a higher recurrence rate. We described determinants of recurrence in subjects with a residual jump. METHODS: We analyzed the data of subjects with acute successful slow pathway cryoablation for AVNRT using a 6-mm-tip cryocatheter. Success was defined as AVNRT non-inducibility. Patients with no baseline elicitable jump, no inducible AVNRT, and transient first atrioventricular (AV) block at the last site were excluded. RESULTS: From 371 patients who underwent cryoablation from May 2002 to March 2011, 303 fulfilled the entry criteria (mean age, 41 ± 16; 222 women). Baseline AV nodal effective refractory period (ERP) was 272 ± 57 ms, postprocedural 331 ± 64 (P < 0.001), and the mean of the difference (Δ ERP) 60 ± 41. At the end of the procedure, 64 patients (21 %) had a residual jump, of whom 22 with a single echo. At 12 months follow-up, the actuarial recurrence-free rate was 70.3 % in patients with a residual jump and 86 % in those without (P = 0.01). In patients with a jump, only Δ AV nodal ERP was correlated with recurrence (37 ± 41 vs. 68 ± 47 ms; P < 0.04) while a single echo was not. The actuarial rate of recurrence was 60.8 % in patients with a Δ AV nodal ERP ≤ 30 ms and 18.8 % in those with a Δ AV nodal ERP >30 ms (P < 0.01). CONCLUSIONS: Suppression of slow pathway conduction is the optimal endpoint for AVNRT cryoablation. A residual jump can be tolerated if AV nodal ERP postcryoablation is prolonged >30 ms. Springer US 2012-05-05 2012 /pmc/articles/PMC3435514/ /pubmed/22562357 http://dx.doi.org/10.1007/s10840-012-9680-7 Text en © The Author(s) 2012 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Article
Tonet, Joelci
De Sisti, Antonio
Pardo Restrepo, Natalia
Raguin, Denis
Amara, Walid
Márquez, Manlio F.
Aouate, Philip
Waintraub, Xavier
Touil, Faouzi
Hidden-Lucet, Francoise
Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
title Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
title_full Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
title_fullStr Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
title_full_unstemmed Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
title_short Post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
title_sort post-ablation prolongation of atrioventricular nodal refractory period is correlated with long-term success of cryoablation for atrioventricular nodal reentrant tachycardia in the case of the persistence of a residual jump
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435514/
https://www.ncbi.nlm.nih.gov/pubmed/22562357
http://dx.doi.org/10.1007/s10840-012-9680-7
work_keys_str_mv AT tonetjoelci postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT desistiantonio postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT pardorestreponatalia postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT raguindenis postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT amarawalid postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT marquezmanliof postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT aouatephilip postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT waintraubxavier postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT touilfaouzi postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump
AT hiddenlucetfrancoise postablationprolongationofatrioventricularnodalrefractoryperiodiscorrelatedwithlongtermsuccessofcryoablationforatrioventricularnodalreentranttachycardiainthecaseofthepersistenceofaresidualjump