Ablation of AV reentrant tachycardia

AV reentrant tachycardia (AVRT) occurs in bouts or attacks, triggered by a circular pattern of electrical impulses between the atria and the ventricles. Catheter ablation is the standard method of treatment for AVRT.

What is AV reentrant tachycardia?

AV reentrant tachycardia, also referred to as Wolff-Parkinson-White-Syndrome, is characterized by an additional pathway - termed an accessory conduction pathway - between the atria and ventricles. This is situated next to the AV node, which is normally the only electrical pathway between these two chambers of the heart.

Frequently, this results in electrical impulses entering a circular pattern between the atrium and the ventricle, producing a very rapid heartbeat which the affected person experiences as severe palpitations.

Development of catheter ablation

For years, catheter ablation has been established as an effective treatment for patients with accessory conduction pathways.

When should catheter ablation be used in patients with AV reentrant tachycardia?

This treatment approach is suitable for use in patients with an accessory conduction pathway between the atrium and the ventricle. (Wolff-Parkinson-White-Syndrome, Mahaim fibers).

How does catheter ablation work in patients with AV reentrant tachycardia?

For patients with recurrent episodes of tachycardia, catheter ablation is the treatment of choice. Ablation of the additional conduction pathway between the atrium and the ventricle is associated with a very high success rate (>95 %).

Prior to the procedure
The examination takes place in a specially equipped catheterization laboratory - our electrophysiology laboratory. Prior to undergoing the actual procedure, you will be connected to a number of different monitors (e.g. ECG). This allows continuous monitoring of your heart function throughout the procedure. 



During the procedure

At the start of the procedure, a local anesthetic is used to numb the area around the entry site(s), which is (are) usually on the right side of the groin. Electrophysiology catheters (thin, flexible probes) are introduced into the blood vessels and advanced to the heart. These catheters can record ECG readings from the inside of the heart, and are positioned using x-ray guidance.

We will usually try to trigger your arrhythmia by using tiny, imperceptible electrical impulses. This is done in order to establish whether your arrhythmia is in fact an AVRT.

Should this be the case, the additional accessory pathway will be identified and ablated. To do so, the relevant area is heated to approximately 50°C for the duration of a few seconds. This results in the treated area no longer being able to conduct electrical impulses. Once the relevant area has been successfully ablated, the procedure is often interrupted for a considerable period of time, in order to determine whether the ablated tissue is likely to recover. At the end of the procedure, the catheters are removed. 



After the procedure
You will remain in the catheterization laboratory while a pressure bandage is applied to the access site. This will need to remain in place for a number of hours (exact duration to be determined after the procedure), which means you will be required to stay in bed. You will usually be able to eat and drink as soon as you are back on the ward.



Discharge from hospital
It is usually possible for patients to be discharged the day after the procedure.

At home
After being discharged, you should try to avoid physical activity for a duration of one week. 
Recurrence of this form of arrhythmia after successful ablation is possible but rare.


 
 
 
 
Relevant information

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Contact person

  • Univ.-Prof. Dr. med.
    Christian Butter
    Head of the Department of Cardiology, Immanuel Hospital Bernau Brandenburg Heart Center

    PA to Head of Department Christine Meinecke
    Immanuel Hospital Bernau Brandenburg Heart Center
    Ladeburger Str. 17
    16321 Bernau bei Berlin
    T +49 3338 694-610
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