Karine Guerrier, DO, MPH
Background: Catheter ablation of the slow atrioventricular (AV) nodal pathway is a safe and effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). While AVNRT occurs frequently in both children and adults, pediatric patients experience higher rates of AVNRT recurrence.
Objective: The purpose of this study was to characterize changes in AV nodal conduction properties following catheter ablation and correlate these properties with AVNRT recurrence in pediatric patients.
Methods: This was a retrospective review of patients aged(AVRT) at a single tertiary care center between January 01, 2010 and September 01, 2021. Demographics, pre- and post-ablation ECG intervals, and AV nodal conduction properties were compared between AVNRT patients with and without recurrence as well as between patients with AVNRT versus AVRT.
Results: Data from 148 patients were analyzed, of which 73 (49%) were female and mean age was 13 ± 3 years. There were 71 patients with AVNRT, of which 65 (92%) had typical AVNRT and 69 (99%) were ablated with cryothermal energy. Four patients (6%) had AVNRT recurrence within 5 years. Baseline demographics were not different in patients with recurrence compared to those without recurrence. There was no significant difference in post-ablation PR interval (p=0.28), AH interval (p=0.38), Wenckebach cycle length (p=0.94) or effective refractory period (p=0.25) between patients with versus without AVNRT recurrence. Presence of post-ablation AV nodal echo beats did not predict risk of recurrence (p=0.99). The pre-ablation effective refractory period (ERP) was similar in AVNRT and AVRT patients (p=0.8); however, patients with AVNRT had longer post ablation ERP (p
Conclusions: In this pediatric cohort, changes in AV node conduction properties seen at electrophysiology study do not correlate with risk of AVNRT recurrence.
DeCarr, Kimberly M. , "Utility of AV Nodal Characteristics in Identification of Atrioventricular Nodal Reentrant Tachycardia and Risk of Recurrence" (2022). Longitudinal Scholar's Project. Paper 18. http://dx.doi.org/10.21007/com.lsp.2022.0015.