Comparative Atrioventricular Node Properties After Radiofrequency Ablation and Operative Therapy of Atrioventricular Node Reentry
Identifieur interne : 004422 ( Main/Exploration ); précédent : 004421; suivant : 004423Comparative Atrioventricular Node Properties After Radiofrequency Ablation and Operative Therapy of Atrioventricular Node Reentry
Auteurs : Andrea Natale [Canada] ; Mark Wathen [Canada] ; Kevin Wolfe [Canada] ; Raymond Yee [Canada] ; Gerard M. Guiraudon [Canada] ; George J. Klein [Canada]Source :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1993-05.
English descriptors
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Abstract
The anatomical substrate for atrioventricular (AV) node reentry is unclear. To gain insights into the mechanism of cure of AV node reentry by nonpharmacological techniques, we compared AV node properties in 53 patients undergoing operative therapy (perinodal dissection) and 43 undergoing radiofrequency ablation (28 posterior approach, 15 anterior approach). Anterior radiofrequency ablation was associated with significant AH prolongation (62 ±18 msec vs 136 ± 64 msec, P < 0.0001), loss of “fast” pathway physiology, and no change in the anterograde refractory period of the AV node (273 ± 24 msec vs 268 ± 28 msec, P = NS). Posterior radiofrequency ablation did not change the AH interval (67 ± 17 msec vs 68 ± 17 msec, P = NS), prolonged AV node effective refractory period (275 ± 48 msec vs 320 ± 55 msec, P < 0.0001), and was associated with loss of “slow pathway” physiology. Operative treatment prolonged the AH interval (66 ±18 msec vs 83 ± 37 msec, P < 0.0001) and the AV node effective refractory period (264 ± 52 msec vs 364 ±112 msec, P < 0.0001), and affected dual pathway physiology inconsistently. These data support the view that the “fast” and “slow” pathways are distinct perinodal entities that can be selectively ablated. The operative approach causes more diffuse and variable injury to the AV node region.
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DOI: 10.1111/j.1540-8159.1993.tb04570.x
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Guiraudon</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Address for reprints: George J. Klein, M.D., University Hospital, Box 5339, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1993-05">1993-05</date><biblScope unit="volume">16</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="971">971</biblScope><biblScope unit="page" to="977">977</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">DAE644FC89AAB19E5F3B4604BDBEF6EBFBDDFEB3</idno><idno type="DOI">10.1111/j.1540-8159.1993.tb04570.x</idno><idno type="ArticleID">PACE971</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AV node reentry</term><term>catheter ablation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The anatomical substrate for atrioventricular (AV) node reentry is unclear. To gain insights into the mechanism of cure of AV node reentry by nonpharmacological techniques, we compared AV node properties in 53 patients undergoing operative therapy (perinodal dissection) and 43 undergoing radiofrequency ablation (28 posterior approach, 15 anterior approach). Anterior radiofrequency ablation was associated with significant AH prolongation (62 ±18 msec vs 136 ± 64 msec, P < 0.0001), loss of “fast” pathway physiology, and no change in the anterograde refractory period of the AV node (273 ± 24 msec vs 268 ± 28 msec, P = NS). Posterior radiofrequency ablation did not change the AH interval (67 ± 17 msec vs 68 ± 17 msec, P = NS), prolonged AV node effective refractory period (275 ± 48 msec vs 320 ± 55 msec, P < 0.0001), and was associated with loss of “slow pathway” physiology. Operative treatment prolonged the AH interval (66 ±18 msec vs 83 ± 37 msec, P < 0.0001) and the AV node effective refractory period (264 ± 52 msec vs 364 ±112 msec, P < 0.0001), and affected dual pathway physiology inconsistently. These data support the view that the “fast” and “slow” pathways are distinct perinodal entities that can be selectively ablated. The operative approach causes more diffuse and variable injury to the AV node region.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Natale, Andrea" sort="Natale, Andrea" uniqKey="Natale A" first="Andrea" last="Natale">Andrea Natale</name></noRegion><name sortKey="Guiraudon, Gerard M" sort="Guiraudon, Gerard M" uniqKey="Guiraudon G" first="Gerard M." last="Guiraudon">Gerard M. Guiraudon</name><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><name sortKey="Wathen, Mark" sort="Wathen, Mark" uniqKey="Wathen M" first="Mark" last="Wathen">Mark Wathen</name><name sortKey="Wolfe, Kevin" sort="Wolfe, Kevin" uniqKey="Wolfe K" first="Kevin" last="Wolfe">Kevin Wolfe</name><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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