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Europace Advance Access published online on July 10, 2006
Europace, doi:10.1093/europace/eul064
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© The European Society of Cardiology 2006. All rights reserved
Received May 7, 2005
Accepted April 18, 2006

Article

Junctional rhythm quantity and duration during slow pathway radiofrequency ablation in patients with atrioventricular nodal re-entry supraventricular tachycardia

Z. Iakobishvili 1, J. Kusniec 1, R. Shohat-Zabarsky 1, A. Mazur 1, A. Battler 1, and B. Strasberg 1 *

1 Department of Cardiology, Rabin Medical Center, Beilinson Campus, 39 Jabotinsky Street, Petah Tikva, Israel 49100; The Sackler Faculty of Medicine, Tel Aviv University, Israel

* To whom correspondence should be addressed.
B. Strasberg, E-mail: strasbergb{at}clalit.org.il


  Abstract

Aim The occurrence of accelerated junctional rhythm during radiofrequency energy delivery at the region of the slow pathway is a well-recognized marker of successful treatment of atrioventricular nodal re-entry tachycardia (AVNRT). Our aim was to evaluate if the quantity and duration of accelerated junctional rhythm during radiofrequency ablation of the slow pathway is correlated with residual slow pathway conduction.

Methods and results Forty consecutive patients with AVNRT undergoing radiofrequency ablation of slow pathway who developed accelerated junctional rhythm during ablation were included. We compared accelerated junctional rhythm quantity and duration between two groups: group A, without echo beats and group B, with echo beats on post-ablation electrophysiology study. The total amount of accelerated junctional rhythm was significantly greater in group A than in group B [75.0 (63.5-165.0) vs. 36.0 (24.0-65.0), P = 0.006], as well as total duration of accelerated junctional rhythm [47.0(33.5-81.0) s vs. 23.0 (16.0-42.0) s, P = 0.006]. The cycle length of accelerated junctional rhythm did not differ between the two groups [510.0 (445.0-545.0) ms vs. 500.0 (450.0-585.0) ms, P = 0.5).

Conclusions The amount and duration of accelerated junctional rhythm is correlated with the total abolishment abolition of slow pathway conduction. A higher amount and duration of accelerated junctional rhythm during radiofrequency applications may be an additional marker of successful ablation.

Keywords: Atrioventricular nodal re-entry tachycardia; Ablation; Junctional ectopy; Echo beats.
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