Clin Res Cardiol 108, Suppl 1, April 2019

Outcomes in patients with dual antegrade conduction in the atrioventricular node – a multicentre observational study

J. Hartmann1, C. Jungen1, S. Stec2, H. Makimoto3, M. Martinek4, H. Pürerfellner4, C. Meyer1, S. Willems1

1Klinik für Kardiologie mit Schwerpunkt Elektrophysiologie, Universitäres Herzzentrum Hamburg GmbH, Hamburg; 2University of Rzeszow, Rzeszow, PL; 3Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Düsseldorf; 4Krankenhaus der Elisabethinen, Linz, AT;

AIMS: To analyse outcomes in patients with the often misdiagnosed dual antegrade atrioventricular (AV) nodal conduction. METHOD AND RESULTS: In this multicentre observational study data from four European centres were studied. Dual antegrade conduction was documented in sixteen patients between 2012 and 2018. Seven out of eleven patients with documented dual AV nodal non-re-entrant tachycardia (DAVNNT) had a delay of the correct diagnosis of more than eleven months after initial consultation of a cardiologist. Misdiagnoses were atrial fibrillation (n=3), atrial (n=3) and ventricular tachycardia (n=2). Two of the primarily misdiagnosed patients received prescription of non-indicated oral anticoagulation, two further patients suffered from inadequate ICD shocks. Slow pathway modulation/ablation was effective, safe and resulted in symptom improvement in all patients. During follow-up there was no evidence of dual antegrade AV nodal conduction in fourteen out of fifteen patients (93.3%). CONCLUSION: This multicentre observational study demonstrates that dual antegrade conduction in the atrioventricular node is more common than previously thought. Misdiagnosis often results in inappropriate and potentially harmful therapies while catheter ablation appears to be safe and efficient.

https://www.abstractserver.com/dgk2019/jt/abstracts//V417.htm