Universität zu Köln

Hartmann, Jens, Jungen, Christiane, Stec, Sebastian ORCID: 0000-0002-9862-318X, Klatt, Niklas, Willems, Stephan, Makimoto, Hisaki, Steven, Daniel, Puererfellner, Helmut, Martinek, Martin and Meyer, Christian (2020). Outcomes in patients with dual antegrade conduction in the atrioventricular node: insights from a multicentre observational study. Clin. Res. Cardiol., 109 (8). S. 1025 - 1035. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1861-0692

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Abstract

Background Supraventricular tachycardias induced by dual antegrade conduction via the atrioventricular (AV) node are rare but often misdiagnosed with severe consequences for the affected patients. As long-term follow-up in these patients was not available so far, this study investigates outcomes in patients with dual antegrade conduction in the AV node. Methods and results In this multicentre observational study, patients from six European centres were studied. Catheter ablation was performed in 17 patients (52 +/- 16 years) with dual antegrade conduction via both AV nodal pathways between 2012 and 2018. Patients with the final diagnosis of a manifest dual AV nodal non-re-entrant tachycardia had a mean delay of the correct diagnosis of over 1 year (range 2-31 months). Two patients received prescription of non-indicated oral anticoagulation, two further patients suffered from inappropriate shocks of an implantable cardioverter defibrillator. In 12 patients, a co-existence of dual antegrade and re-entry conduction in the AV node was present. Mean fast pathway conduction time was 138 +/- 61 ms and mean slow pathway conduction time was 593 +/- 134 ms. Successful radiofrequency catheter ablation was performed in all patients. Post-procedurally oral anticoagulation was discontinued, without detection of cerebrovascular events or atrial fibrillation during a long-term follow-up of median 17 months (range 6-72 months). Conclusion This first multicentre study investigating patients with supraventricular tachycardia and dual antegrade conduction in the AV node demonstrates that catheter ablation is safe and effective while long-term patient outcome is good. Autonomic tone dependent changes in ante- vs. retrograde conduction via slow and/or fast pathway can challenge the diagnosis and therapy in some patients. [GRAPHICS] .

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hartmann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Jungen, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Stec, Sebastian UNSPECIFIED orcid.org/0000-0002-9862-318X UNSPECIFIED Klatt, Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Willems, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Makimoto, Hisaki UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Puererfellner, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Martinek, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Meyer, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-347997
DOI:	10.1007/s00392-020-01596-y
Journal or Publication Title:	Clin. Res. Cardiol.
Volume:	109
Number:	8
Page Range:	S. 1025 - 1035
Date:	2020
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1861-0692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TACHYCARDIA-INDUCED CARDIOMYOPATHY; NARROW COMPLEX TACHYCARDIA; SUPRAVENTRICULAR TACHYCARDIA; CATHETER ABLATION; SLOW-PATHWAY; NONREENTRANT TACHYCARDIA; REENTRANT TACHYCARDIA; GUIDELINES Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34799