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Multiple multisite low-temperature and low-power radiofrequency currents for the induction of atrioventricular nodal reentry tachycardia in non-inducible patients

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Abstract

Aims

Some patients with documented episodes of paroxysmal supraventricular tachycardia (PSVT) do not have inducible tachycardia during the electrophysiological study. In this study, we describe how multiple low-temperature, low-power radiofrequency (RF) currents in the atrioventricular (AV) junction region can increase the rate of the induction of atrioventricular nodal reentrant tachycardia (AVNRT) in non-inducible cases.

Method

We enrolled 31 consecutive patients (mean age = 50.9 ± 11.9 years; 5 [16.1 %] male) who presented with documented clinical PSVT in superficial electrocardiography but had non-inducible arrhythmia in the electrophysiology laboratory despite applying different stimulation protocols. We delivered low-power (25 W), low-temperature (45 °C) RF currents into the AV junction region to induce AVNRT.

Results

Arrhythmia was induced in 20 (64.5 %) patients, and it was non-sustained in 3 (9.6 %) patients. RF current was delivered into the posterior region near the coronary sinus ostium and midseptal region. RF ablation target in inducible patients was the non-inducibility of the AVNRT at the end of the procedure, while the target in the non-inducible patients was slow pathway ablation with no antegrade conduction over the slow pathway. During the follow-up period, none of the patients (either with inducible or non-inducible arrhythmia) had recurrence of AVNRT.

Conclusion

Multiple low-power, low-temperature RF current application into the AV junction region is a more effective method for the induction of AVNRT in comparison with a single current use into the slow pathway.

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Abbreviations

AV:

Atrioventricular

AVNRT:

Atrioventricular nodal reentrant tachycardia

IQR:

Interquartile range

PSVT:

Paroxysmal supraventricular tachycardia

RF:

Radiofrequency

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Acknowledgments

This study was supported by Tehran Heart Center and Tehran University of Medical Sciences.

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Authors and Affiliations

  1. Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

    Ahmad Yaminisharif, Seyed Mostafa Seyed Hoseini & Akbar Shafiee

  2. Department of Electrophysiology, Tehran Heart Center, North Kargar Ave., Tehran, 1411713138, Iran

    Ahmad Yaminisharif

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  1. Ahmad Yaminisharif
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  2. Seyed Mostafa Seyed Hoseini
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  3. Akbar Shafiee
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Correspondence to Ahmad Yaminisharif.

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Yaminisharif, A., Hoseini, S.M.S. & Shafiee, A. Multiple multisite low-temperature and low-power radiofrequency currents for the induction of atrioventricular nodal reentry tachycardia in non-inducible patients. J Interv Card Electrophysiol 42, 5–9 (2015). https://doi.org/10.1007/s10840-014-9955-2

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  • DOI: https://doi.org/10.1007/s10840-014-9955-2

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