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Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia.
Pacing Clin Electrophysiol. 2005 Feb; 28(2):111-8.PC

Abstract

BACKGROUND

Junctional rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined.

METHODS

Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HA(SVT)) and JR (HA(JR)) were analyzed.

RESULTS

In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HA(JR) was significantly shorter than the HA(SVT) (57 +/- 24 vs 68 +/- 21 ms, P < 0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HA(JR) was also significantly shorter than the HA(SVT) (145 +/- 27 vs 168 +/- 29 ms, P = 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7 (100%) patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P < 0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs 1/27, P < 0.01).

CONCLUSIONS

In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.

Authors+Show Affiliations

Cardiovascular Research Center and Division of Cardiology, Department of Medicine, National Yang-Ming University, Veterans General Hospital-Taipei, Taiwan, ROC. shlee@cm1.ethome.net.twNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15679640

Citation

Lee, Shih-Huang, et al. "Electrophysiological Characteristics of Junctional Rhythm During Ablation of the Slow Pathway in Different Types of Atrioventricular Nodal Reentrant Tachycardia." Pacing and Clinical Electrophysiology : PACE, vol. 28, no. 2, 2005, pp. 111-8.
Lee SH, Tai CT, Lee PC, et al. Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia. Pacing Clin Electrophysiol. 2005;28(2):111-8.
Lee, S. H., Tai, C. T., Lee, P. C., Chiang, C. E., Cheng, J. J., Ueng, K. C., Chen, Y. J., Hsieh, M. H., Tsai, C. F., Chiou, C. W., Yu, W. C., Kuo, J. Y., Tsao, H. M., Lee, K. T., & Chen, S. A. (2005). Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia. Pacing and Clinical Electrophysiology : PACE, 28(2), 111-8.
Lee SH, et al. Electrophysiological Characteristics of Junctional Rhythm During Ablation of the Slow Pathway in Different Types of Atrioventricular Nodal Reentrant Tachycardia. Pacing Clin Electrophysiol. 2005;28(2):111-8. PubMed PMID: 15679640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia. AU - Lee,Shih-Huang, AU - Tai,Ching-Tai, AU - Lee,Pi-Chang, AU - Chiang,Chern-En, AU - Cheng,Jun-Jack, AU - Ueng,Kow-Chang, AU - Chen,Yi-Jen, AU - Hsieh,Ming-Hsiung, AU - Tsai,Chin-Feng, AU - Chiou,Chuen-Wang, AU - Yu,Wen-Chung, AU - Kuo,Jen-Yuan, AU - Tsao,Hsuan-Ming, AU - Lee,Kun-Tai, AU - Chen,Shih-Ann, PY - 2005/2/1/pubmed PY - 2005/6/3/medline PY - 2005/2/1/entrez SP - 111 EP - 8 JF - Pacing and clinical electrophysiology : PACE JO - Pacing Clin Electrophysiol VL - 28 IS - 2 N2 - BACKGROUND: Junctional rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. METHODS: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HA(SVT)) and JR (HA(JR)) were analyzed. RESULTS: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HA(JR) was significantly shorter than the HA(SVT) (57 +/- 24 vs 68 +/- 21 ms, P < 0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HA(JR) was also significantly shorter than the HA(SVT) (145 +/- 27 vs 168 +/- 29 ms, P = 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7 (100%) patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P < 0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs 1/27, P < 0.01). CONCLUSIONS: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia. SN - 0147-8389 UR - https://www.unboundmedicine.com/medline/citation/15679640/Electrophysiological_characteristics_of_junctional_rhythm_during_ablation_of_the_slow_pathway_in_different_types_of_atrioventricular_nodal_reentrant_tachycardia_ L2 - https://doi.org/10.1111/j.1540-8159.2005.09430.x DB - PRIME DP - Unbound Medicine ER -