AV Nodal Reentrant Tachycardia Study (AVNRT)
|Tachycardia, Atrioventricular Nodal Reentry||Procedure: Cardiac Invasive Electrophysiological Study|
|Study Design:||Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Diagnostic
|Official Title:||Localization of the Anterograde and Retrograde Components of the Reentrant Circuit of AV Nodal Reentrant Tachycardia|
- raise the frequency of success to more than 98% [ Time Frame: unk ]
|Study Start Date:||March 2004|
|Estimated Study Completion Date:||March 2020|
|Estimated Primary Completion Date:||March 2020 (Final data collection date for primary outcome measure)|
Mapping and Ablation
Procedure: Cardiac Invasive Electrophysiological Study
Mapping and localizing of the components of the reentrant circuit as part of the Electrophysiological Study
- The Tendon of Todaro forms a line of block during slow/fast AVNRT preventing the atrial impulse from entering the triangle of Koch (and perhaps providing sufficient time for activation to pass through the coronary sinus coat to activate the posterior extensions of the AV node as is critical to maintenance of tachycardia)
- The coronary sinus myocardial coat participates in all of the forms of AVNRT. The reentrant circuit is thus not confined within the triangle of Koch and sites remote from the compact AV node could be targeted for ablation reducing the risk of AV conduction block.
- A model of the reentrant circuit can be created for each patient's tachycardia, using the site of earliest retrograde activation to suggest the retrograde limb and the resetting response to suggest the anterograde limb.
Resetting and Mapping of AV nodal reentrant tachycardia:
Pacing will be analyzed to see at which sites, the tachycardia can be reset by the latest extra-stimuli (i.e., with the least advancement in local activation). The coupling interval will be compared to the latest extra-stimulus capable of resetting (advancing) the tachycardia from the postero-septal tricuspid annulus.
The patients will act as their own reference, since the standard ablation technique in the postero-septal space is being performed first and tested for efficacy. The McNemar test will be applied to compare the efficacy of ablation at the postero-septal tricuspid annulus alone (standard ablation), with the efficacy of this ablation plus ablation within the coronary sinus. From our initial observations, It is anticipated that the additional ablation in the coronary sinus will increase the efficacy of the procedure from <95% to >98%, such that 100 cases should provide sufficient data to reach statistical significance.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00618683
|Contact: Deborah Lockwood, M.D.||405-271 9696 ext firstname.lastname@example.org|
|Contact: Kathy Drennan, RN||405-271 email@example.com|
|United States, Oklahoma|
|The University of Oklahoma Health Sciences Center||Recruiting|
|Oklahoma City, Oklahoma, United States, 73104|
|Contact: Kathy Drennan, RN 405-271-2299 Kathy-Drennan@ouhsc.edu|
|Principal Investigator: Deborah Lockwood, M.D.|
|Principal Investigator:||Deborah Lockwood, M.D.||University of Oklahoma|