Radiofrequency Catheter Ablation of Atrioventricular Junctional ("AV Nodal") Reentrant Tachycardia in Patients with Implantable Cardioverter Defibrillators

Catheter ablation of tachycardias has been undertaken successfully in patients with ICDs without damage to the ICD or lead. Ablation of the slow AV nodal pathway, however, is technically challenging because the lead of the ICD lies close to the ablation site. We report successful ablation of AV Junctional reentrant tachycardia (AVJRT) in three patients with ICDs, In all cases, the ablation site was within a few millimeters of the ICD lead. The ablation was successful in all cases and did not cause damage to the ICD or lead. The patients have remained free of recurrence of AVJRT during a mean follow-up of 12 months.