Long term success of slow pathway ablation
Feldman et al reported high long-term success with slow pathway ablation in 1419 patients with AVNRT31. Independent predictors of AVNRT recurrence were age < 20 years and female gender. No significant difference in the incidence of late recurrence was observed in presence or absence of residual slow pathway conduction, use of isoproterenol testing or general anaesthesia31. Katritis et al reported non inducibility despite isoproterenol challenge as the most reliable predictor of clinical success in a retrospective analysis of 1007 patients who underwent RFA for AVNRT8. The presence of junctional rhythm during ablation was highly sensitive but not specific for procedural success nor was the presence of residual slow pathway conduction. Jentzer et al reported the individual response to RFA 26 in 52 patients with AVNRT. RF was delivered for 20-40seconds prior to testing and terminated prematurely in the presence of JA block. In keeping with the present study, procedural success was associated with a longer duration of junctional beats and total number of junctional beats but not the cycle length of JR. EP testing was only performed if RF was delivered for ≥ 20 seconds and included some cases retrospectively.