Ablation of nonparoxysmal A-V nodal tachycardia.

The present study describes the successful radiofrequency ablation of an uncommon type of A-V nodal tachycardia. Electroanatomical mapping of the right atria was used to locate the region of the earliest atrial activation and allowed for positioning of the ablation catheter and a successful 25-watt radiofrequency burn in this area terminating the tachycardia. The ability to visualize multiple projections of pertinent intracardiac structures allows a more rapid and systematic approach by marking all ablation points even in the presence of AV block or AV dissociation. Consequently, repeated burns can be eliminated in previously treated areas by electroanatomical mapping of the earliest depolarization and leading pacemaker.