Outcome of slow pathway modulation for atrioventricular nodal reentrant tachycardia with 50 versus 30 watts-more power, more effect?
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Outcome of slow pathway modulation for atrioventricular nodal reentrant tachycardia with 50 versus 30 watts-more power, more effect? / Dechering, Dirk G; Schleberger, Ruben; Greiser, Eva; Dickow, Jannis; Koebe, Julia; Frommeyer, Gerrit; Willems, Stephan; Eckardt, Lars; Hoffmann, Boris A; Wasmer, Kristina.
in: J INTERV CARD ELECTR, Jahrgang 52, Nr. 2, 07.2018, S. 157-161.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Outcome of slow pathway modulation for atrioventricular nodal reentrant tachycardia with 50 versus 30 watts-more power, more effect?
AU - Dechering, Dirk G
AU - Schleberger, Ruben
AU - Greiser, Eva
AU - Dickow, Jannis
AU - Koebe, Julia
AU - Frommeyer, Gerrit
AU - Willems, Stephan
AU - Eckardt, Lars
AU - Hoffmann, Boris A
AU - Wasmer, Kristina
PY - 2018/7
Y1 - 2018/7
N2 - PURPOSE: Slow pathway modulation is the treatment of choice in patients with atrioventricular nodal reentrant tachycardia (AVNRT). No comparative data on ablation strategies exist. Therefore, we sought to compare two common ablation approaches.METHODS: We analyzed prospective ablation databases of two high-volume tertiary centers (> 1000 ablations/year) using either 30 or 50 W for slow pathway modulation from 2012 to 2013. We analyzed procedural characteristics as well as short- and long-term outcomes. Mean follow-up was 36 ± 9 months.RESULTS: Six hundred thirty-four patients (50 W center: n = 342, 30 W center: n = 292) were ablated. Slow pathway modulation was successful in 99% in both groups (p = ns). Periprocedural AV block occurred in nine patients (2.6%) in the 50 W and five patients (1.7%) in the 30 W group (p = 0.59), respectively. We documented no permanent higher-degree AV block. The number of RF lesions and seconds of RF delivery was significantly less in the 50 W group (p = 0.04 for number of lesions; p < 0.001 for seconds). AVNRT recurrence was similar (p = 0.23). In males, significantly fewer recurrences accrued in the 50 W group (p = 0.04), while in females less transient AV blocks occurred during the procedure with 30 W (p = 0.07).CONCLUSIONS: The 30 and 50 W target power approaches for slow pathway modulation are highly effective and safe. Significantly, fewer RF duration was necessary to modulate the slow pathway with higher power output (50 W). Our subgroup analysis suggests that males and females might benefit most from different modulation approaches.
AB - PURPOSE: Slow pathway modulation is the treatment of choice in patients with atrioventricular nodal reentrant tachycardia (AVNRT). No comparative data on ablation strategies exist. Therefore, we sought to compare two common ablation approaches.METHODS: We analyzed prospective ablation databases of two high-volume tertiary centers (> 1000 ablations/year) using either 30 or 50 W for slow pathway modulation from 2012 to 2013. We analyzed procedural characteristics as well as short- and long-term outcomes. Mean follow-up was 36 ± 9 months.RESULTS: Six hundred thirty-four patients (50 W center: n = 342, 30 W center: n = 292) were ablated. Slow pathway modulation was successful in 99% in both groups (p = ns). Periprocedural AV block occurred in nine patients (2.6%) in the 50 W and five patients (1.7%) in the 30 W group (p = 0.59), respectively. We documented no permanent higher-degree AV block. The number of RF lesions and seconds of RF delivery was significantly less in the 50 W group (p = 0.04 for number of lesions; p < 0.001 for seconds). AVNRT recurrence was similar (p = 0.23). In males, significantly fewer recurrences accrued in the 50 W group (p = 0.04), while in females less transient AV blocks occurred during the procedure with 30 W (p = 0.07).CONCLUSIONS: The 30 and 50 W target power approaches for slow pathway modulation are highly effective and safe. Significantly, fewer RF duration was necessary to modulate the slow pathway with higher power output (50 W). Our subgroup analysis suggests that males and females might benefit most from different modulation approaches.
KW - Adult
KW - Aged
KW - Cardiac Electrophysiology
KW - Catheter Ablation/methods
KW - Cohort Studies
KW - Databases, Factual
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Recurrence
KW - Risk Assessment
KW - Sensitivity and Specificity
KW - Severity of Illness Index
KW - Statistics, Nonparametric
KW - Tachycardia, Atrioventricular Nodal Reentry/diagnostic imaging
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1007/s10840-018-0360-0
DO - 10.1007/s10840-018-0360-0
M3 - SCORING: Journal article
C2 - 29556909
VL - 52
SP - 157
EP - 161
JO - J INTERV CARD ELECTR
JF - J INTERV CARD ELECTR
SN - 1383-875X
IS - 2
ER -