Partial and Complete Ablation of the Slow Pathway in Patients with Atrioventricular Nodal Reentrant Tachycardia: Comparing the Complications and Recurrence

Background and Catheter radiofrequency ablation is the first step in therapeutic approach to Atrioventricular nodal reentrant tachycardia (AVNRT). Different protocols for slow pathway ablation are found to have various ranges of efficacy and side effects. This study compared the effects of partial and complete ablation of the slow pathway on recurrence, symptom relief and complications in patients with AVNRT. In a cohort study100 patients with accurate diagnosis of AVNRT were recruited from Baqiyatallah Hospital during 2009-2011. Atropine (0.04 mg/kg) and Propranolol (0.2 mg/kg) were used for autonomic blockage. Electrophysiology study was used to evaluate the remaining slow pathway function following ablation. The research population included 40 male and 60 female. The mean age of the patients was 43 ± 13. Forty eight cases were found with incomplete slow pathway ablation while complete ablation was seen in 52 cases. No considerable adverse reaction to the study medication was observed among the patients. Moreover, we did not find any significant recurrence symptoms (palpitations, chest pain and fainting) after ablation between the two groups (P<0.05). However, complications such as AV block, DVT, and pericardial effusion were significantly different among the two groups (P<0.05). The symptoms improved in both groups but complications were seen less in partial ablation. Excessive effort for ablating the reentry pathway in patients with AVNRT leads to more complications, however, the rate of success remains similar.