AIMS: To conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT). METHODS AND RESULTS: Patients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120-300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a 'pill in the pocket' approach. The primary endpoint of the study was hospital admission for persistent tachycardia cardioversion, during a follow-up period of 5 years. Sixty-one patients were included in the study. In the ablation group, 1 patient was lost to follow-up, and 29 were free of arrhythmia or conduction disturbances at a 5-year follow-up. In the AAD group, three patients were lost to follow-up. Of the remainder, 10 patients (35.7%) continued with initial therapy, 11 patients (39.2%) remained on diltiazem alone, and 7 patients (25%) interrupted their therapy within the first 3 months following randomization, and subsequently developed an episode requiring cardioversion. During a follow-up of 5 years, 21 patients in the AAD group required hospital admission for cardioversion. Survival free from the study endpoint was significantly higher in the ablation group compared with the AAD group (log-rank test, P < 0.001). CONCLUSIONS: Catheter ablation is the therapy of choice for symptomatic AVNRT. Antiarrhythmic drug therapy is ineffective and not well tolerated. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: To conduct a randomized trial in order to guide the optimum therapy of symptomatic atrioventricular nodal re-entrant tachycardia (AVNRT). METHODS AND RESULTS: Patients with at least one symptomatic episode of tachycardia per month and an electrophysiologic diagnosis of AVNRT were randomly assigned to catheter ablation or chronic antiarrhythmic drug (AAD) therapy with bisoprolol (5 mg od) and/or diltiazem (120-300 mg od). All patients were properly educated to treat subsequent tachycardia episodes with autonomic manoeuvres or a 'pill in the pocket' approach. The primary endpoint of the study was hospital admission for persistent tachycardia cardioversion, during a follow-up period of 5 years. Sixty-one patients were included in the study. In the ablation group, 1 patient was lost to follow-up, and 29 were free of arrhythmia or conduction disturbances at a 5-year follow-up. In the AAD group, three patients were lost to follow-up. Of the remainder, 10 patients (35.7%) continued with initial therapy, 11 patients (39.2%) remained on diltiazem alone, and 7 patients (25%) interrupted their therapy within the first 3 months following randomization, and subsequently developed an episode requiring cardioversion. During a follow-up of 5 years, 21 patients in the AAD group required hospital admission for cardioversion. Survival free from the study endpoint was significantly higher in the ablation group compared with the AAD group (log-rank test, P < 0.001). CONCLUSIONS: Catheter ablation is the therapy of choice for symptomatic AVNRT. Antiarrhythmic drug therapy is ineffective and not well tolerated. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Demosthenes G Katritsis; Giuseppe Boriani; Francisco G Cosio; Pierre Jais; Gerhard Hindricks; Mark E Josephson; Roberto Keegan; Bradley P Knight; Karl-Heinz Kuck; Deirdre A Lane; Gregory Yh Lip; Helena Malmborg; Hakan Oral; Carlo Pappone; Sakis Themistoclakis; Kathryn A Wood; Kim Young-Hoon; Carina Blomström Lundqvist Journal: Arrhythm Electrophysiol Rev Date: 2016
Authors: Lucas Hollanda Oliveira; Mateus Dos Santos Viana; Christian Moreno Luize; Ricardo Sobral de Carvalho; Claudio Cirenza; Cristiano de Oliveira Dietrich; Luis Claudio Correia; Claudio das Virgens; Juliana Medeiros Filgueiras; Mauricio Barreto; Emerson Porto; Enia Coutinho; Ângelo de Paola Journal: J Am Heart Assoc Date: 2022-06-03 Impact factor: 6.106
Authors: Dirk G Dechering; Ruben Schleberger; Eva Greiser; Jannis Dickow; Julia Koebe; Gerrit Frommeyer; Stephan Willems; Lars Eckardt; Boris A Hoffmann; Kristina Wasmer Journal: J Interv Card Electrophysiol Date: 2018-03-19 Impact factor: 1.900
Authors: Felix K Wegner; Simon Kochhäuser; Gerrit Frommeyer; Philipp S Lange; Christian Ellermann; Patrick Leitz; Patrick Müller; Julia Köbe; Lars Eckardt; Dirk G Dechering Journal: Clin Res Cardiol Date: 2021-05-07 Impact factor: 5.460