Changes in AV Node Conduction Curves Following Slow Pathway Modification.

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Bibliographic Details
Title:	Changes in AV Node Conduction Curves Following Slow Pathway Modification.
Authors:	Geller, J. Christoph¹ Christoph.Geller@medizin-uni-magdeburg.de, Goette, Andreas¹, Reek, Sven¹, Funke, Corinna¹, Hartung, Wolfgang M.¹, Klein, Helmut U.¹
Source:	Pacing & Clinical Electrophysiology. Nov2000, Vol. 23 Issue 11, p1651-1660. 10p.
Subjects:	Atrioventricular node, Heart conduction system, Patients, Tachycardia, Electrotherapeutics, Electrophysiology
Abstract:	Dual AV node physiology often persists after successful slow pathway (SP) ablation, and the mechanism of tachycardia elimination is unresolved. Therefore, AV node conduction curves were analyzed following successful ablation (4 ± 1 energy applications) in 85 consecutive patients (58 women, age 50 ± 2 years) with typical AVNRT. Twenty-seven patients (32%) had complete elimination (group 1) whereas 58 (68%) patients had persistence (group 2) of dual AV node physiology. A significant increase in the AV node Wenckebach cycle length (WB-CL) was observed in both groups (310 ± 9 to 351 ±15 ms in group 1, and 325 ± 8 to 369 ± 9 ms in group 2.P < 0.05). A decrease in the fast pathway (FP) ERP (339 ± 15 to 279 ± 12 ms) and an increase in the maximum FP AH interval (141 ± 5 to 171 ±7) were observed only in group 1 (P < 0.05). In group 2, no change in the SP FRP (267 ± 7 to 280 ± 10 ms) was observed, and the change in the maximum SP-AH following ablation showed a significant inverse relation to the maximum SP-AH at baseline in group 2. In conclusion, (1) an increase in the WB-CL is observed independent of the persistence or elimination of dual physiology after successful ablation; (2) when dual physiology is eliminated, significant changes in the FP ERP and the maximum FP-AH occur; (3) when dual physiology persists, FP physiology and the SP FRP remain unchanged, and a significant inverse relation between the change in the maximum SP-AH following ablation and the maximum baseline SP-AH is observed. [ABSTRACT FROM AUTHOR]
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Database:	Engineering Source

Description
Abstract:	Dual AV node physiology often persists after successful slow pathway (SP) ablation, and the mechanism of tachycardia elimination is unresolved. Therefore, AV node conduction curves were analyzed following successful ablation (4 ± 1 energy applications) in 85 consecutive patients (58 women, age 50 ± 2 years) with typical AVNRT. Twenty-seven patients (32%) had complete elimination (group 1) whereas 58 (68%) patients had persistence (group 2) of dual AV node physiology. A significant increase in the AV node Wenckebach cycle length (WB-CL) was observed in both groups (310 ± 9 to 351 ±15 ms in group 1, and 325 ± 8 to 369 ± 9 ms in group 2.P < 0.05). A decrease in the fast pathway (FP) ERP (339 ± 15 to 279 ± 12 ms) and an increase in the maximum FP AH interval (141 ± 5 to 171 ±7) were observed only in group 1 (P < 0.05). In group 2, no change in the SP FRP (267 ± 7 to 280 ± 10 ms) was observed, and the change in the maximum SP-AH following ablation showed a significant inverse relation to the maximum SP-AH at baseline in group 2. In conclusion, (1) an increase in the WB-CL is observed independent of the persistence or elimination of dual physiology after successful ablation; (2) when dual physiology is eliminated, significant changes in the FP ERP and the maximum FP-AH occur; (3) when dual physiology persists, FP physiology and the SP FRP remain unchanged, and a significant inverse relation between the change in the maximum SP-AH following ablation and the maximum baseline SP-AH is observed. [ABSTRACT FROM AUTHOR]
ISSN:	01478389
DOI:	10.1046/j.1460-9592.2000.01651.x