The importance of sustained junctional tachycardia following cessation of radiofrequency current delivery in slow pathway ablation

Autor:	Nader Asgary, Bahamin Amirabadi, Alireza Malekrah, Alireza Fattahian
Rok vydání:	2021
Předmět:	Adult Male medicine.medical_specialty Slow pathway Radiofrequency ablation medicine.medical_treatment Atrial overdrive pacing law.invention Postoperative Complications law Internal medicine Tachycardia Ectopic Junctional medicine Humans Tachycardia Atrioventricular Nodal Reentry Cycle length Coronary sinus business.industry Cardiac Pacing Artificial General Medicine Middle Aged medicine.disease Ablation Junctional tachycardia Cardiology Catheter Ablation Female Supraventricular tachycardia Cardiology and Cardiovascular Medicine business
Zdroj:	Pacing and clinical electrophysiology : PACEREFERENCES. 44(12)
ISSN:	1540-8159
Popis:	BACKGROUND Apart from junctional rhythms during slow pathway ablation, there is limited knowledge about the junctional tachycardia persisting following ablation cessation. This study is conducted to determine the characteristics and significance of this rare arrhythmia. METHODS AND RESULTS This study was done on 487 patients with AVNRT undergoing the radiofrequency ablation. The RF delivery-induced Supraventricular Tachycardia, persisting for a few minutes following the termination of ablation (post-ablation SVT) was investigated in this research. Atrial Overdrive Pacing (AOP) was applied to the post-ablation SVT to distinguish AVNRT from Junctional Tachycardia(JT). A total of 2337 RF-current deliveries were applied, and post-ablation SVT was observed in 81 of them. According to the electrophysiological studies, five of them (in five separate cases) were definitely diagnosed as JT. The overall incidence of post-ablation JT was about 1% of all patients. In these cases, RF energy was applied to the posteroseptal region and roof of the proximal coronary sinus. The mean Cycle Length (CL) of JTs was equal to 446 ±67ms. Following post- ablation JT termination, four cases met endpoints of successful ablation, demonstrating a positive predictive value of 80%. Atrioventricular (AV) block did not occur in any of the cases and reappearance of JT was not observed during procedure or mean follow-up period of 19.8 ± 8.4 months. CONCLUSIONS Post-ablation JT is probably a transient Ischemia-induced arrhythmia that does not require further ablation. Thus, it is recommended to differentiate between the AVNRT and JT in post-ablation arrhythmias to avoid unnecessary RF application.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9370b42f963fb90afbcf1e00b93d60b6 https://pubmed.ncbi.nlm.nih.gov/34624139 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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