Favorable outcome using an abbreviated procedure for catheter ablation of AVNRT: results from a prospective randomized trial

Abstract

Introduction: Radiofrequency catheter ablation aiming slow pathway modulation is a widely established procedure with high success and low recurrence rates in patients with atrioventricular nodal reentry tachycardia (AVNRT). However, the necessity of a waiting period following successful slow pathway modulation to increase the long-term success rates has not been systematically evaluated thus far.

Methods and results: This prospective study comprised 138 consecutive patients (mean age 50.3 +/- 15.1 years) with AVNRT. These patients were randomly assigned to two groups: in group I (n = 70), a waiting period of 30 min was part of the procedure, whereas in group II (n = 68), the procedure ended without a waiting period. Electrophysiological standard parameters, i.e., ERP of RA, fast and slow pathway, RV as well as antegrade and retrograde AV node conduction capacity, were assessed prior to and after the ablation. During a follow-up period of 22.8 +/- 5.9 months, four patients in group I and three patients in group II developed recurrence of AVNRT (4.9%; P = 0.4). The mean procedure time was 115.1 +/- 23.6 min in the group with and 88.9 +/- 23.3 min in the group without waiting period (P = 0.009). No high degree AV-node conduction block was observed during the study.

Conclusion: In the present study we could show that no long-term benefit results from a 30 min waiting period for patients who underwent an acutely successful catheter ablation for AVNRT. We therefore conclude that a 30-min waiting period can be omitted in standard procedures, thus resulting in significant shorter procedure durations.