RT-157
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Slow pathway in the treatment of
junctional reciprocating tachycardia
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Domenico Potenza, Ennio Pisano,
Raimondo Massaro, Nicola Cianfrone, Raffaele Fanelli.
Department of Cardiology, I.R.C.C.S. "Casa Sollievo della Sofferenza",
S. Giovanni Rotondo, Italy
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Abstract
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Atrioventricular (AV) node modification through the
selective ablation of the so called "slow pathway" is a safe way to eradicate
junctional reciprocating tachycardia with a low risk of AV block. In our
electrophysiological laboratory 90 patients underwent slow pathway ablation. In the first
cases we looked for slow pathway potentials previously described, then we used a modified
approach that is the research of aspecific fragmented potentials in postero-septal space;
this method is quick and effective. Three specific post-ablative patterns associated with
success were founded: a) complete ablation of the slow pathway with great increase of
effective antegrade refractory period of AV junction; b) residual AV node duality with
small increase of AV refractoriness; c) no change in AV antegrade curve. The type of
post-ablative pattern does not correlate with the recurrences that seem to be associated
with the pure anatomic approach. No AV block was observed in the follow-up.
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Key Words
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Catheter ablation of supraventricular
tachyarrhythmias
atrioventricular junctional reciprocating tachycardia, slow pathway ablation, AV node
modification, junctional accelerated rhythm, OA
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