Absence of junctional rhythm during successful slow-pathway ablation in patients with atrioventricular nodal reentrant tachycardia

The presence of junctional rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, junctional rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch's triangle, and successful ablation was a...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1998-11, Vol.98 (21), p.2296-2300
Main Authors: HSIEH, M.-H, CHEN, S.-A, TAI, C.-T, YU, W.-C, CHEN, Y.-J, CHANG, M.-S
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Atrioventricular Node - physiopathology
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Catheter Ablation
Electrocardiography - methods
Electrophysiology
Female
Heart
Humans
Male
Medical sciences
Middle Aged
Predictive Value of Tests
Retrospective Studies
Tachycardia, Atrioventricular Nodal Reentry - physiopathology
Tachycardia, Atrioventricular Nodal Reentry - therapy
Treatment Outcome
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Summary:The presence of junctional rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, junctional rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch's triangle, and successful ablation was achieved in the absence of a junctional rhythm. This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50+/-17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without junctional rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with junctional rhythm (P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.98.21.2296