Journal article
Anatomical Ablation of the Atrioventricular Node
Arrhythmia & electrophysiology review, Vol.13, p.e12
03/01/2024
DOI: 10.15420/aer.2024.13
PMCID: PMC11363056
PMID: 39221060
Abstract
Background: Atrioventricular (AV) conduction ablation has been achieved by targeting the area of penetration of the conduction axis as defined by recording a His bundle potential. Ablation of the His bundle may reduce the possibility of a robust junctional escape rhythm. It was hypothesised that specific AV nodal ablation is feasible and safe. Methods: The anatomical position of the AV node in relation to the site of penetration of the conduction axis was identified as described in dissections and histological sections of human hearts. Radiofrequency (RF) ablation was accomplished based on the anatomical criteria. Results: Specific anatomical ablation of the AV node was attempted in 72 patients. Successful AV nodal ablation was accomplished in 63 patients (87.5%), following 60 minutes (IQR 50-70 minutes) of procedure time, 3.4 minutes (IQR 2.4-5.5 minutes) of fluoroscopy time, and delivery of 4 (IQR 3-6) RF lesions. Alpha n escape rhythm was present in 45 patients (71%), and the QRS complex was similar to that before ablation in all 45 patients. Atropine was administered in six patients after the 10-min waiting period and did not result in restoration of conduction. In nine patients, AV conduction could not be interrupted, and AV block was achieved with ablation of the His after delivery of 12 (IQR 8-15) RF lesions. No cases of sudden death were encountered, and all patients had persistent AV block during a median 10.5 months (IQR 5-14 months) of follow-up. Conclusion: Anatomical ablation of the AV node is feasible and safe, and results in an escape rhythm similar to that before ablation.
Details
- Title: Subtitle
- Anatomical Ablation of the Atrioventricular Node
- Creators
- Demosthenes G. Katritsis - Hygeia HospitalKonstantinos C. Siontis - Mayo Clinic in ArizonaSharad Agarwal - Papworth HospitalStavros Stavrakis - Oklahoma City UniversityEleftherios Giazitzoglou - Hygeia HospitalHina Amin - Mayo Clinic in ArizonaJoseph E. Marine - Johns Hopkins HospitalJustin Tretter - Cleveland ClinicDamian Sanchez-Quintana - Universidad de ExtremaduraRobert H. Anderson - Newcastle UniversityHugh Calkins - Johns Hopkins Hospital
- Resource Type
- Journal article
- Publication Details
- Arrhythmia & electrophysiology review, Vol.13, p.e12
- DOI
- 10.15420/aer.2024.13
- PMID
- 39221060
- PMCID
- PMC11363056
- NLM abbreviation
- Arrhythm Electrophysiol Rev
- ISSN
- 2050-3369
- eISSN
- 2050-3377
- Publisher
- Radcliffe Cardiology
- Number of pages
- 6
- Language
- English
- Date published
- 03/01/2024
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984961112902771
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