Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia

Shih Huang Lee, Ching Tai Tai, Pi Chang Lee, Chern En Chiang, Jun Jack Cheng, Kow Chang Ueng, Yi Jen Chen, Ming Hsiung Hsieh, Chin Feng Tsai, Chuen Wang Chiou, Wen Chung Yu, Jen Yuan Kuo, Hsuan Ming Tsao, Kun Tai Lee, Shih Ann Chen

Research output: Contribution to journalArticle

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Abstract

Background: Junctional rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HASVT) and JR (HAJR) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HAJR was significantly shorter than the HASVT (57 ± 24 vs 68 ± 21 ms, P <0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HAJR was also significantly shorter than the HASVT (145 ± 27 vs 168 ± 29 ms, P = 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7 (100%) patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P <0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs 1/27, P <0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.

Original languageEnglish
Pages (from-to)111-118
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume28
Issue number2
DOIs
Publication statusPublished - Feb 2005
Externally publishedYes

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Atrioventricular Nodal Reentry Tachycardia
Bundle of His

Keywords

  • Ablation
  • Atrioventricular nodal
  • Junctional rhythm
  • Tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia. / Lee, Shih Huang; Tai, Ching Tai; Lee, Pi Chang; Chiang, Chern En; Cheng, Jun Jack; Ueng, Kow Chang; Chen, Yi Jen; Hsieh, Ming Hsiung; Tsai, Chin Feng; Chiou, Chuen Wang; Yu, Wen Chung; Kuo, Jen Yuan; Tsao, Hsuan Ming; Lee, Kun Tai; Chen, Shih Ann.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 28, No. 2, 02.2005, p. 111-118.

Research output: Contribution to journalArticle

Lee, Shih Huang ; Tai, Ching Tai ; Lee, Pi Chang ; Chiang, Chern En ; Cheng, Jun Jack ; Ueng, Kow Chang ; Chen, Yi Jen ; Hsieh, Ming Hsiung ; Tsai, Chin Feng ; Chiou, Chuen Wang ; Yu, Wen Chung ; Kuo, Jen Yuan ; Tsao, Hsuan Ming ; Lee, Kun Tai ; Chen, Shih Ann. / Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia. In: PACE - Pacing and Clinical Electrophysiology. 2005 ; Vol. 28, No. 2. pp. 111-118.
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title = "Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia",
abstract = "Background: Junctional rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HASVT) and JR (HAJR) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4{\%}) patient. The HAJR was significantly shorter than the HASVT (57 ± 24 vs 68 ± 21 ms, P <0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45{\%}), and to that of the retrograde intermediate pathway in 6 (55{\%}) patients. Transient retrograde conduction block during JR was noted in 1 (9{\%}) patient. The HAJR was also significantly shorter than the HASVT (145 ± 27 vs 168 ± 29 ms, P = 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7 (100{\%}) patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P <0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs 1/27, P <0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.",
keywords = "Ablation, Atrioventricular nodal, Junctional rhythm, Tachycardia",
author = "Lee, {Shih Huang} and Tai, {Ching Tai} and Lee, {Pi Chang} and Chiang, {Chern En} and Cheng, {Jun Jack} and Ueng, {Kow Chang} and Chen, {Yi Jen} and Hsieh, {Ming Hsiung} and Tsai, {Chin Feng} and Chiou, {Chuen Wang} and Yu, {Wen Chung} and Kuo, {Jen Yuan} and Tsao, {Hsuan Ming} and Lee, {Kun Tai} and Chen, {Shih Ann}",
year = "2005",
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language = "English",
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TY - JOUR

T1 - Electrophysiological characteristics of junctional rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia

AU - Lee, Shih Huang

AU - Tai, Ching Tai

AU - Lee, Pi Chang

AU - Chiang, Chern En

AU - Cheng, Jun Jack

AU - Ueng, Kow Chang

AU - Chen, Yi Jen

AU - Hsieh, Ming Hsiung

AU - Tsai, Chin Feng

AU - Chiou, Chuen Wang

AU - Yu, Wen Chung

AU - Kuo, Jen Yuan

AU - Tsao, Hsuan Ming

AU - Lee, Kun Tai

AU - Chen, Shih Ann

PY - 2005/2

Y1 - 2005/2

N2 - Background: Junctional rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HASVT) and JR (HAJR) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HAJR was significantly shorter than the HASVT (57 ± 24 vs 68 ± 21 ms, P <0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HAJR was also significantly shorter than the HASVT (145 ± 27 vs 168 ± 29 ms, P = 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7 (100%) patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P <0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs 1/27, P <0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.

AB - Background: Junctional rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HASVT) and JR (HAJR) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HAJR was significantly shorter than the HASVT (57 ± 24 vs 68 ± 21 ms, P <0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HAJR was also significantly shorter than the HASVT (145 ± 27 vs 168 ± 29 ms, P = 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7 (100%) patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P <0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs 1/27, P <0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.

KW - Ablation

KW - Atrioventricular nodal

KW - Junctional rhythm

KW - Tachycardia

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U2 - 10.1111/j.1540-8159.2005.09430.x

DO - 10.1111/j.1540-8159.2005.09430.x

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JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

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