PROLONGED MONITORING FOR DETECTION OF SYM PTOMATIC ARRHYTHMIAS AFTER SLOW PATHWAY ABLATION IN AV-NODAL TACHYCARDIA

To study the incidence of symptoms and recurrences of AV-nodal re-entr ant tachycardia (AVNT) after treatment with radio-frequency ablation o f the slow pathway, event recording with transtelephonic transmission was performed for at least 3 weeks in 19 patients out of a series of 2 5. Follow-up with an implanted antitachycardia device was possible in two other patients, making the total number under continued surveillan ce 21/25. The period of monitoring was prolonged as complaints remaine d or became present after 1 month in eight patients. During a mean fol low-up of 10 months, late recurrence of AVNT was observed in this way in 4/25 patients; they were submitted to a second procedure. Symptoms were present in many others and were explained by the recordings. Sinu s tachycardia was recorded in three patients, intermittent AV-block of the first degree in another, and frequent atrial or ventricular prema ture beats in six patients. These minor arrhythmias tended to decrease over time. A coexistent atrial tachycardia was redetected in two pati ents. Thus, event recording is useful to distinguish recurrence of AVN T, sinus tachycardia, other types of supraventricular tachycardia, and atrial or ventricular premature beats, which all may be a reason of c omplaints during the first weeks after ablation. It provided a feeling of safety for symptomatic patients who often suffered from anxiety be fore the ablation.