Atrioventricular block occurring several months after radiofrequency ablation for the treatment of atrioventricular nodal re-entrant tachycardia.

Abstract

Atrioventricular (AV) block following radiofrequency (RF) ablation for the treatment of AV nodal re-entrant tachycardia (AVNRT) is a rare but well recognised complication of the procedure--the reported incidence ranges from 1% to 21%. Almost all cases of AV block occur during or shortly after the procedure, are transient, and recover quickly. Two patients (a 22 year man and a 72 year old woman) with symptomatic AV block occurring several months after slow pathway RF ablation, requiring permanent pacemaker implantation, are described. Both patients had had several 24 hour Holter recordings before the procedure, and in neither case was there any evidence of intermittent or persistent AV block. This is a rare complication with no definitive predictors; however, all efforts should be made to exclude AV block in patients presenting with suggestive symptoms following RF ablation. With the wide use of RF ablation for the treatment of AVNRT, more cases are likely to occur. A registry should allow documentation of the incidence of this complication.

AI evidence extraction

Main findings

Two patients developed symptomatic AV block several months after slow pathway radiofrequency ablation for AVNRT, requiring permanent pacemaker implantation. Both had multiple 24-hour Holter recordings before the procedure with no evidence of intermittent or persistent AV block.

Outcomes measured

• Atrioventricular (AV) block occurring several months after RF ablation
• Permanent pacemaker implantation

Limitations

• Case report of two patients; no control group
• No RF exposure parameters (e.g., frequency, dose) reported
• Cannot estimate incidence or identify predictors from this report alone

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "radiofrequency ablation (medical procedure)",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Two patients with AV nodal re-entrant tachycardia treated with slow pathway radiofrequency ablation (22-year-old man; 72-year-old woman)",
    "sample_size": 2,
    "outcomes": [
        "Atrioventricular (AV) block occurring several months after RF ablation",
        "Permanent pacemaker implantation"
    ],
    "main_findings": "Two patients developed symptomatic AV block several months after slow pathway radiofrequency ablation for AVNRT, requiring permanent pacemaker implantation. Both had multiple 24-hour Holter recordings before the procedure with no evidence of intermittent or persistent AV block.",
    "effect_direction": "harm",
    "limitations": [
        "Case report of two patients; no control group",
        "No RF exposure parameters (e.g., frequency, dose) reported",
        "Cannot estimate incidence or identify predictors from this report alone"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency ablation",
        "atrioventricular block",
        "AVNRT",
        "slow pathway",
        "pacemaker",
        "complication",
        "Holter monitoring"
    ],
    "suggested_hubs": []
}

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