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May 1, 1996American Heart JournalOpen Access

Localization of the origin of the atrioventricular junctional rhythm induced during selective ablation of slow-pathway conduction in patients with atrioventricular node reentrant tachycardia

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Key result

Atrioventricular junctional activity was observed in 98% of successful slow-pathway ablations versus 43% of unsuccessful attempts, indicating its absence strongly predicts an unsuccessful application.

Why the study?

Does the presence and origin of atrioventricular junctional rhythm predict successful radiofrequency ablation of slow-pathway conduction in patients with AVNRT?

Population

43 consecutive patients with atrioventricular node reentrant tachycardia undergoing selective ablation of…

Comparison

Radiofrequency catheter ablation of slow-pathway… vs Unsuccessful ablation attempts and pacing from…

Design

Cohort

Authors

JYJohn YuMLMichael R. LauerCYCharlie Young

Discussion

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Overview

Junctional rhythm during slow pathway ablation is sensitive but nonspecific for success; leaves open its role as a reliable procedural endpoint.

Study Design

Type

Observational (n=43)

Structured PICO

Does the presence and origin of atrioventricular junctional rhythm predict successful radiofrequency ablation of slow-pathway conduction in patients with AVNRT?

P
Population
43 consecutive patients with atrioventricular node reentrant tachycardia undergoing selective ablation of slow-pathway conduction.
E
Exposure
Radiofrequency catheter ablation of slow-pathway conduction
C
Comparator
Unsuccessful ablation attempts (for frequency of junctional activity) and pacing from right ventricular apex/successful ablation site (for retrograde activation sequence)
O
Outcome
Frequency of atrioventricular junctional activity and its correlation with successful vs unsuccessful ablation attemptssurrogate

Main Result

Absolute Event Rate: 98% vs 43%

The absence of atrioventricular junctional rhythm during radiofrequency ablation strongly predicts an unsuccessful attempt at slow-pathway ablation in AVNRT, and these beats appear to exit remotely from the anterior atrial septal region.

Cite This Study

Yu et al. (1996) conducted an observational in Atrioventricular node reentrant tachycardia (n=43). Successful radiofrequency ablation of slow-pathway conduction vs. Unsuccessful ablation attempts was evaluated on Atrioventricular junctional activity. Atrioventricular junctional activity was observed in 98% of successful slow-pathway ablations versus 43% of unsuccessful attempts, indicating its absence strongly predicts an unsuccessful application.

synapsesocial.com/papers/6a5efebae4dd0931747e115bhttps://doi.org/10.1016/s0002-8703(96)90176-3
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Autonomic control of pacemaker activity in the atrioventricular junction of the dog1978 · 29 citations
  2. 2Sequence of retrograde atrial activation in patients with dual atrioventricular nodal pathways.1981 · 195 citations
  3. 3Temperature monitoring during radiofrequency catheter ablation procedures using closed loop control. Atakr Multicenter Investigators Group.1994 · 143 citations
  4. 4Influence of the Direction of the Atrial Wave Front on A-V Nodal Transmission in Isolated Hearts of Rabbits1969 · 140 citations
  5. 5Demonstration of Dual A-V Nodal Pathways in Patients with Paroxysmal Supraventricular Tachycardia1973 · 537 citations