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Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes
BACKGROUND: Left-sided ablation, targeting left inferior AV nodal extensions, is thought to be necessary for success in a small proportion of atrioventricular nodal re-entrant tachycardia (AVNRT) ablations; however Indian data are scarce in this regard. METHODS: Consecutive cases of AVNRT undergoing...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7854377/ https://www.ncbi.nlm.nih.gov/pubmed/33129971 http://dx.doi.org/10.1016/j.ipej.2020.10.004 |
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author | Narayanan, Kumar Omer, Mohammed Arif, Mohammed Sridhar, Papani Annarapu, Nitin Naidu, Shivaprasad Jariwala, Pankaj Kavalipati, Narasaraju Madivada, Mukharjee Balaji, Ramagiri M, Premchand Reddy A, Sharath Krishna G, Anil EA, Padmakumar |
author_facet | Narayanan, Kumar Omer, Mohammed Arif, Mohammed Sridhar, Papani Annarapu, Nitin Naidu, Shivaprasad Jariwala, Pankaj Kavalipati, Narasaraju Madivada, Mukharjee Balaji, Ramagiri M, Premchand Reddy A, Sharath Krishna G, Anil EA, Padmakumar |
author_sort | Narayanan, Kumar |
collection | PubMed |
description | BACKGROUND: Left-sided ablation, targeting left inferior AV nodal extensions, is thought to be necessary for success in a small proportion of atrioventricular nodal re-entrant tachycardia (AVNRT) ablations; however Indian data are scarce in this regard. METHODS: Consecutive cases of AVNRT undergoing slow pathway ablation in a single centre over an 18-month period were retrospectively analyzed. Left-sided ablation at the posteroseptal mitral annulus was performed if right-sided ablation failed to abolish AVNRT. RESULTS: From January 2017 to June 2018, out of 215 consecutive supraventricular tachycardia (SVT) cases, 154 (71.6%) were AVNRT (47.1 ± 13.1 years, 46.1% male). Trans-septal ablation was required in 5 (3.2%) cases (mean age 48.8 ± 9.4 years; 4 female, 1 male); all with typical (slow-fast) form of AVNRT. Compared with cases needing only right-sided ablation, radiofrequency time (50.8 ± 16.9 vs. 9.9 ± 8.5 min; p = 0.005) and procedure time (166.0 ± 35.0 vs 79.6 ± 35.9 min; p = 0.004) were significantly longer for trans-septal cases, while baseline intervals and tachycardia cycle length were not significantly different. Junctional ectopy was seen in only 2 of the 5 cases during left-sided ablation, but acute success (non-inducibility) was obtained in 3 cases. There were no instances of AV block. Over mean follow-up of 12.2 ± 4.0 months, clinical recurrence of AVNRT occurred in one case, while others remained arrhythmia-free without medication. CONCLUSION: Left-sided ablation was required in a small proportion of AVNRT ablations. Trans-septal approach targeting the posteroseptal mitral annulus was safe and yielded good mid-term clinical success. |
format | Online Article Text |
id | pubmed-7854377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-78543772021-02-05 Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes Narayanan, Kumar Omer, Mohammed Arif, Mohammed Sridhar, Papani Annarapu, Nitin Naidu, Shivaprasad Jariwala, Pankaj Kavalipati, Narasaraju Madivada, Mukharjee Balaji, Ramagiri M, Premchand Reddy A, Sharath Krishna G, Anil EA, Padmakumar Indian Pacing Electrophysiol J Original Article BACKGROUND: Left-sided ablation, targeting left inferior AV nodal extensions, is thought to be necessary for success in a small proportion of atrioventricular nodal re-entrant tachycardia (AVNRT) ablations; however Indian data are scarce in this regard. METHODS: Consecutive cases of AVNRT undergoing slow pathway ablation in a single centre over an 18-month period were retrospectively analyzed. Left-sided ablation at the posteroseptal mitral annulus was performed if right-sided ablation failed to abolish AVNRT. RESULTS: From January 2017 to June 2018, out of 215 consecutive supraventricular tachycardia (SVT) cases, 154 (71.6%) were AVNRT (47.1 ± 13.1 years, 46.1% male). Trans-septal ablation was required in 5 (3.2%) cases (mean age 48.8 ± 9.4 years; 4 female, 1 male); all with typical (slow-fast) form of AVNRT. Compared with cases needing only right-sided ablation, radiofrequency time (50.8 ± 16.9 vs. 9.9 ± 8.5 min; p = 0.005) and procedure time (166.0 ± 35.0 vs 79.6 ± 35.9 min; p = 0.004) were significantly longer for trans-septal cases, while baseline intervals and tachycardia cycle length were not significantly different. Junctional ectopy was seen in only 2 of the 5 cases during left-sided ablation, but acute success (non-inducibility) was obtained in 3 cases. There were no instances of AV block. Over mean follow-up of 12.2 ± 4.0 months, clinical recurrence of AVNRT occurred in one case, while others remained arrhythmia-free without medication. CONCLUSION: Left-sided ablation was required in a small proportion of AVNRT ablations. Trans-septal approach targeting the posteroseptal mitral annulus was safe and yielded good mid-term clinical success. Elsevier 2020-10-28 /pmc/articles/PMC7854377/ /pubmed/33129971 http://dx.doi.org/10.1016/j.ipej.2020.10.004 Text en © 2020 Indian Heart Rhythm Society. Production and hosting by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Narayanan, Kumar Omer, Mohammed Arif, Mohammed Sridhar, Papani Annarapu, Nitin Naidu, Shivaprasad Jariwala, Pankaj Kavalipati, Narasaraju Madivada, Mukharjee Balaji, Ramagiri M, Premchand Reddy A, Sharath Krishna G, Anil EA, Padmakumar Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes |
title | Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes |
title_full | Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes |
title_fullStr | Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes |
title_full_unstemmed | Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes |
title_short | Left sided ablation for Atrioventricular Nodal Re-entrant Tachycardia: Frequency, Characteristics and Outcomes |
title_sort | left sided ablation for atrioventricular nodal re-entrant tachycardia: frequency, characteristics and outcomes |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7854377/ https://www.ncbi.nlm.nih.gov/pubmed/33129971 http://dx.doi.org/10.1016/j.ipej.2020.10.004 |
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