Catheter Ablation of Atypical Atrioventricular Nodal Reentrant Tachycardia

Demosthenes G. Katritsis*, Joseph E. Marine, Fernando M. Contreras, Akira Fujii, Rakesh Latchamsetty, Konstantinos C. Siontis, George D. Katritsis, Theodoros Zografos, Roy M. John, Lawrence M. Epstein, Gregory F. Michaud, Elad Anter, Ali Sepahpour, Edward Rowland, Alfred E. Buxton, Hugh Calkins, Fred Morady, William G. Stevenson, Mark E. Josephson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Because of its low prevalence, data on atypical atrioventricular nodal reentrant tachycardia (AVNRT) are scarce, and the optimal ablation method has not been established. Our study aimed at assessing the efficacy and safety of conventional slow pathway ablation, as applied for typical cases, in atypical AVNRT. Methods: We studied 2079 patients with AVNRT subjected to slow pathway ablation. In 113 patients, mean age 48.5±18.1 years, 68 female, atypical AVNRT or coexistent atypical and typical AVNRT without other concomitant arrhythmia was diagnosed. Ablation data and outcomes were compared with a group of age- and sex-matched control patients with typical AVNRT. Results: Fluoroscopy and radiofrequency current delivery times were not different in the atypical and typical groups, 20.3±12.2 versus 20.8±12.9 minutes (P=0.730) and 5.9±5.0 versus 5.5±4.5 minutes (P=0.650), respectively. Slow pathway ablation was accomplished from the right septum in 110 patients, and from the left septum in 3 patients, in the atypical group. There was no need for additional ablation lesions at other anatomic sites, and no cases of atrioventricular block were encountered. Recurrence rates of the arrhythmia were 5.6% in the atypical (6/108 patients) and 1.8% in the typical (2/111 patients) groups in the next 3 months following ablation (P=0.167). Conclusions: Conventional ablation at the anatomic area of the slow pathway is the therapy of choice for symptomatic AVNRT, regardless of whether the typical or atypical form is present.

Original languageEnglish
Pages (from-to)1655-1663
Number of pages9
Issue number21
StatePublished - 22 Nov 2016
Externally publishedYes


  • arrhythmias, cardiac
  • atrioventricular node
  • catheter ablation
  • tachycardia
  • tachycardia, atrioventricular nodal reentry


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