Key result
Catheter ablation of the AV junction for refractory supraventricular arrhythmias resulted in a reliable escape rhythm in only 40% of patients during a mean follow-up of 30 months.
Why the study?
Does catheter ablation of the atrioventricular conduction system lead to a reliable subsidiary escape rhythm in patients with refractory supraventricular arrhythmias?
Observational (n=30)
Does catheter ablation of the atrioventricular conduction system lead to a reliable subsidiary escape rhythm in patients with refractory supraventricular arrhythmias?
Catheter ablation of the AV junction frequently leads to pacemaker dependence due to the lack of a reliable escape rhythm, suggesting it should be reserved as a last resort.
May warrant reserving AV junction ablation as last resort; leaves open need for prospective data on escape rhythm reliability.
Underlying Heart Rhythm after Catheter Ablation of the Atrioventricular Conduction System. Catheter fulguration was used to treat 30 patients with refractory supraventricular arrhythmias. Persistent complete heart block was achieved in 23 patients (77%). Two patients (6%) have intermittent complete heart block, and remain asymptomatic without additional drug therapy. In one patient, AV conduction resumed, but the patient became asymptomatic with previously ineffective drugs. The procedure was ineffective in four patients (13%). To assess the long‐term stability of the subsidiary escape rhythm, we describe the underlying heart rhythm, after pacemaker inhibition by chest wall stimulation, on 125 occasions in 25 patients with complete heart block. The mean follow‐up period was 30 months (range: 2–79 months). Ten patients (40%) did have an escape rhythm on every assessment. The cycle length of the subsidiary escape rhythm was 1,380 ± 421 msec (mean $ SD). Catheter ablation of the AV junction should only he used as a last resort, hecause of the possible induction of a pacemaker dependent state. A reliable escape rhythm was present in only 40% of the patients. (J Cardiovasc Electrophysiol, Vol. 1, pp. 209–213, June 1990)
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Vijgen et al. (1990) conducted an observational in refractory supraventricular arrhythmias (n=30). Catheter fulguration (ablation of the AV junction) was evaluated on Presence of a reliable escape rhythm on every assessment. Catheter ablation of the AV junction for refractory supraventricular arrhythmias resulted in a reliable escape rhythm in only 40% of patients during a mean follow-up of 30 months.
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