{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T23:15:59Z","timestamp":1774307759094,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T00:00:00Z","timestamp":1562025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Atrioventricular nodal re\u2010entry tachycardia (AVNRT) is the most common, regular narrow\u2010complex tachycardia. The established treatment is catheter ablation of the AV nodal slow pathway (SP). However, in a select group of patients with long PR intervals in sinus rhythm, SP ablation can lead to AV block due to the absence of robust anterograde conduction through the fast pathway (FP). This report aims to demonstrate that AV nodal FP ablation is a reasonable approach in patients with AVNRT and poor or absent anterograde FP conduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>Standard electrophysiology study techniques were used in the electrophysiology laboratory. Catheter ablations were performed using radiofrequency energy. Mapping of intracardiac activation was performed with electroanatomical mapping systems. Outcomes were assessed acutely during the procedure and during routine clinical follow\u2010up. Six patients with first\u2010degree AV block and recurrent AVNRT who underwent ablation of their tachycardia at our institution are presented. One patient underwent ablation of AV nodal SP resulting in high\u2010degree AV block necessitating pacemaker implantation. The remaining five patients underwent ablation of the AV nodal FP guided by electroanatomical mapping of the earliest atrial activation in tachycardia. These five had successful treatment of the tachycardia with preservation of anterograde AV nodal conduction. Mapping and ablation approach to eliminate retrograde FP conduction are described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In select patients with AVNRT and poor anterograde FP conduction, retrograde FP ablation is reasonable and is less likely to result in AV block and pacemaker dependency.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14012","type":"journal-article","created":{"date-parts":[[2019,6,12]],"date-time":"2019-06-12T06:19:20Z","timestamp":1560320360000},"page":"1569-1577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Should fast pathway ablation be reconsidered in typical atrioventricular nodal re\u2010entrant tachycardia?"],"prefix":"10.1111","volume":"30","author":[{"given":"Stephen","family":"Tuohy","sequence":"first","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin M.","family":"Trulock","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Newton B.","family":"Wiggins","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Bassiouny","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maki","family":"Ono","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric L.","family":"Kiehl","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Cantillon","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khaldoun","family":"Tarakji","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Dresing","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walid","family":"Saliba","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2296-2596","authenticated-orcid":false,"given":"Niraj","family":"Varma","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3983-3515","authenticated-orcid":false,"given":"Patrick","family":"Tchou","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology and Pacing, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,7,2]]},"reference":[{"key":"e_1_2_9_1_2_1","doi-asserted-by":"publisher","DOI":"10.15420\/AER.2016.18.2"},{"key":"e_1_2_9_1_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.86.3.919"},{"key":"e_1_2_9_1_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.3.827"},{"key":"e_1_2_9_1_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199207303270504"},{"key":"e_1_2_9_1_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90686-U"},{"key":"e_1_2_9_1_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.4.1318"},{"key":"e_1_2_9_1_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90768-V"},{"key":"e_1_2_9_1_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.08.856"},{"key":"e_1_2_9_1_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.046"},{"key":"e_1_2_9_1_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.9.2705"},{"key":"e_1_2_9_1_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00310-X"},{"key":"e_1_2_9_1_13_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2002.00203.x"},{"key":"e_1_2_9_1_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(97)70071-1"},{"key":"e_1_2_9_1_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1994.tb01187.x"},{"key":"e_1_2_9_1_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1998.tb00880.x"},{"key":"e_1_2_9_1_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.89.3.1103"},{"key":"e_1_2_9_1_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90050-J"},{"key":"e_1_2_9_1_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1997.tb01825.x"},{"key":"e_1_2_9_1_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.024471"},{"key":"e_1_2_9_1_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90870-2"},{"key":"e_1_2_9_1_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2000.tb01761.x"},{"key":"e_1_2_9_1_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.108.172403"},{"key":"e_1_2_9_1_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.20631"},{"key":"e_1_2_9_1_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.2.164"},{"key":"e_1_2_9_1_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02699.x"},{"key":"e_1_2_9_1_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.2.188"},{"key":"e_1_2_9_1_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2005.06.024"},{"key":"e_1_2_9_1_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/ar.a.20108"},{"key":"e_1_2_9_1_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.17.2110"},{"key":"e_1_2_9_1_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00887-X"},{"key":"e_1_2_9_1_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2006.00537.x"},{"key":"e_1_2_9_1_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02910.x"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14012","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.14012","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.14012","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T20:48:03Z","timestamp":1694292483000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.14012"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,7,2]]},"references-count":32,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1111\/jce.14012"],"URL":"https:\/\/doi.org\/10.1111\/jce.14012","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,7,2]]},"assertion":[{"value":"2019-02-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-07-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}