AVNRT natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ramyar Ghandriz MD[2]
Overview
AVNRT starts and stops abruptly. Patients may develop syncope. The prognosis is good.
Natural History, Complications, Prognosis
Natural History
The rhythm often ceases abruptly and spontaneously. An episode generally last seconds to hours.
Complications
- Some patients will develop syncope during episodes of AVRNT. The mechanism of syncope may be due to a reduction of cardiac output and hemodynamic compromise as a result of the short ventricular filling time or alternatively it may be due to transient asystole due to tachycardia-mediated suppression of the sinus node when the rhythm terminates. Those patients who do become symptomatic during episodes of AVNRT (i.e. have syncope) should avoid activities where the occurrence of hemodynamic compromise would endanger their safety or that of others (like driving).
- In patients with underlying ischemic heart disease, demand-related myocardial ischemia, angina and even myocardial infarction and/or congestive heart failure can occur.
- Tachycardia mediated cardiomyopathy may develop if the AVNRT is chronic and does not terminate.
Prognosis
AVNRT is rarely life threatening and in the absence of underlying structural heart disease, the prognosis is good. Radiofrequency ablation is curative in 95% of cases.