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We applied a new technique of catheter ablation to treat atrioventricular nodal reentrant tachycardia and preserve anterograde conduction, performing this procedure in 21 patients with repetitive episodes of tachycardia refractory to antiarrhythmic drugs. Using atrial activation in the His-bundle lead as a reference, we selected the optimal site of ablation by positioning an electrode catheter so that atrial activation occurred simultaneously with or earlier than the reference activation during tachycardia. At this site, the His-bundle deflection was completely absent or was present only at a low amplitude (less than 0.1 mV). In the majority of patients, these criteria could be met by withdrawing the catheter 5 to 10 mm from the site of the His-bundle recording (adjacent to the reference catheter). Shocks of 160 or 240 J were delivered at this site (cumulative energy [mean +/- SD], 689 +/- 442 J). Treatment resulted in preferential abolition or impairment of retrograde nodal conduction. Anterograde conduction, although modified, was preserved in 19 patients; complete heart block persisted in 2 patients. Sixteen patients remained free of arrhythmia, without medication or implantation of a pacemaker, for a mean follow-up period of 14 +/- 8 months (range, 7 to 42). Tachycardia was not inducible in 14 patients in a follow-up electrophysiologic study performed 3.6 +/- 6 months after the procedure. We conclude that catheter ablation is an effective alternative for the treatment of atrioventricular nodal tachycardia in patients with drug-resistant tachycardia.
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
June 2015,
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M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
November 1994,
Pacing and clinical electrophysiology : PACE,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
September 1984,
The American journal of cardiology,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
January 1992,
Indian heart journal,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
January 2003,
Archivos de cardiologia de Mexico,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
November 1994,
Archives des maladies du coeur et des vaisseaux,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
March 1994,
The Canadian journal of cardiology,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
December 2023,
Herzschrittmachertherapie & Elektrophysiologie,
M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
November 1997,
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M Haissaguerre, and
J F Warin, and
P Lemetayer, and
N Saoudi, and
J P Guillem, and
P Blanchot
January 1993,
Polski tygodnik lekarski (Warsaw, Poland : 1960),
