Background and Objectives : Intracardiac electrocardiographic finding using as a guide
for selective catheter ablation in patients with AV nodal reentrant tachycardia (AVNRT)
is not specific. Therefore, we evaluated the efficacy and safety of the anatomical
approach for catheter ablation in patients with AVNRT.
Methods : Among the patients diagnosed as AVNRT by electrophysiologic study, total
66 patients (M : F= 26 : 40) were included in this study. In the right anterior oblique
radiographic view, the septal annulus of tricuspid valve, extending from the most
posterior region of the annulus adjacent to coronary sinus ostium (posterior) to His
bundle recording site (anterior), was divided into posterior (P), mid (M), and anterior
(A) sites. Radiofrequency (RF) energies were applied from the posterior part to the
anterior part sequentially along the septal annulus of tricuspid valve until successful
ablation.
Results : Successful anatomical sites were located in posterior (11 patients), mid (48
patients), and anterior (7 patients) sites. The most patients (62 patients) were treated
with slow pathway ablation except 4 patients in whom fast pathway was ablated.
Probable slow potentials were observed in 8 patients (12%, 3 in posterior sites and 5 in
mid sites). Transient complete AV black was occured in one case whose ablation site
was A1. And another 3 patients had postablation first degree AV block.
Conclusion : In patients with AVNRT, the ablated pathway were different according to
successful anatomical site. And RF catheter ablation of atrioventricular nodal reentrant
circuit guided by anatomical landmark is safe and efficacious.
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