Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction

Final results of a prospective, multicenter clinical trial

Hugh Calkins, Patrick Yong, John Miller, Brian Olshansky, Mark Carlson, J. Philip Saul, Shoei K. Stephen Huang, L. Bing Liem, Lawrence S. Klein, Suzan A. Moser, Daniel A. Bloch, Paul Gillette, Eric Prystowsky

Research output: Contribution to journalArticle

503 Citations (Scopus)

Abstract

Background - The purpose of this study was to evaluate the safety and efficacy of a temperature-controlled radiofrequency catheter ablation system. Methods and Results - The patient population included 1050 patients who had undergone ablation of atrioventricular nodal reentrant tachycardia (AVNRT), an accessory pathway (AP), or the atrioventricular junction (AVJ). Ablation was successful in 996 patients. The probability of success was highest among patients who had undergone ablation of the AVJ, lowest in patients who had undergone ablation of an AP, and in between for patients who had undergone ablation of AVNRT. A major complication occurred in 32 patients. Four variables predicted ablation success (AVJ, AVNRT, or left free wall AP ablation and an experienced center). Four factors predicted arrhythmia recurrence (right free wall, posteroseptal, septal, and multiple APs). Two variables predicted development of a complication (structural heart disease and the presence of multiple targets), and 3 variables predicted an increased risk of death (heart disease, lower ejection fraction, and AVJ ablation). Conclusions - These findings may serve as a guide to clinicians considering therapeutic options in patients who are candidates for ablation.

Original languageEnglish (US)
Pages (from-to)262-270
Number of pages9
JournalCirculation
Volume99
Issue number2
StatePublished - Jan 19 1999
Externally publishedYes

Fingerprint

Atrioventricular Nodal Reentry Tachycardia
Catheter Ablation
Multicenter Studies
Clinical Trials
Heart Diseases
Accessory Atrioventricular Bundle
Cardiac Arrhythmias
Safety
Recurrence
Temperature

Keywords

  • Atrioventricular node
  • Catheter ablation
  • Complications
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction : Final results of a prospective, multicenter clinical trial. / Calkins, Hugh; Yong, Patrick; Miller, John; Olshansky, Brian; Carlson, Mark; Saul, J. Philip; Stephen Huang, Shoei K.; Liem, L. Bing; Klein, Lawrence S.; Moser, Suzan A.; Bloch, Daniel A.; Gillette, Paul; Prystowsky, Eric.

In: Circulation, Vol. 99, No. 2, 19.01.1999, p. 262-270.

Research output: Contribution to journalArticle

Calkins, H, Yong, P, Miller, J, Olshansky, B, Carlson, M, Saul, JP, Stephen Huang, SK, Liem, LB, Klein, LS, Moser, SA, Bloch, DA, Gillette, P & Prystowsky, E 1999, 'Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: Final results of a prospective, multicenter clinical trial', Circulation, vol. 99, no. 2, pp. 262-270.
Calkins, Hugh ; Yong, Patrick ; Miller, John ; Olshansky, Brian ; Carlson, Mark ; Saul, J. Philip ; Stephen Huang, Shoei K. ; Liem, L. Bing ; Klein, Lawrence S. ; Moser, Suzan A. ; Bloch, Daniel A. ; Gillette, Paul ; Prystowsky, Eric. / Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction : Final results of a prospective, multicenter clinical trial. In: Circulation. 1999 ; Vol. 99, No. 2. pp. 262-270.
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