Transcatheter electrical AV junction ablation: predictors of success
Tony W. Simmons, MDAddress reprint requests to T.W.S., The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Hassan M.K. Nagi, MD
Bruce L. Wilkoff, MD
Victor A. Morant, MD
Richard Sterba, MD
Lon W. Castle, MD
James D. Maloney, MD
The initial and long-term results of transcatheter electrical ablation in 29 patients with drug-refractory supraventricular tachyarrhythmias were analyzed. Ablation was immediately successful (defined as induction of chronic complete heart block) in 25 patients (86.2%). Among the group in whom ablation was unsuccessful, there were more patients with ectopic atrial tachycardia and a higher incidence of narrow QRS escape rhythm following the initial ablation. A His amplitude equal to or greater than 0.3 mV was correlated with success. Complications of ablation included deep venous thrombosis and ventricular arrhythmias. Postablation stress testing was superior to ambulatory monitoring in identifying early return of atrioventricular conduction.