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

Iakobishvili, Zaza; Kusniec, Jairo; Shohat-Zabarsky, R.; Mazur, Alexander; Battler, Alexander; Strasberg, Boris

doi:10.1093/europace/eul064

Cited by 21 publications

(19 citation statements)

References 19 publications

(32 reference statements)

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“…Several investigators have reported persistent junctional rhythm after RF ablation of the slow AV nodal pathway to be a highly predictive measure of successful ablation, reflecting more intense injury from the RF ablation on the peri-AV nodal tissue. [20][21][22] Junctional tachycardia can last seconds to more than 1 hour after RF ablation. 18 Although it is unclear, PO JET might have its origin from the slow AV nodal pathway; thus, to facilitate PO JET, we attempted physical injury (RF ablation and tricuspid valve stretch) to this heart region.…”

Section: Physical Injury To the Csmentioning

confidence: 99%

Newly created animal model of human postoperative junctional ectopic tachycardia

Moak

Mercader

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Experimental junctional ectopic tachycardia or fascicular tachycardia can occur in the intraoperative setting of sinus node dysfunction, prolonged cardiopulmonary bypass, and enhanced conduction system automaticity. Conduction system automaticity occurred after either physical injury (ablation or tricuspid valve stretch) or measures to augment the transient inward current of the conduction system (isoproterenol and digoxin). This animal model can serve as the basis to assess new treatments of postoperative junctional ectopic tachycardia.

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Section: Physical Injury To the Csmentioning

confidence: 99%

Newly created animal model of human postoperative junctional ectopic tachycardia

Moak

Mercader

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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“…Iakobishvili et al (24) reported the cycle length of accelerated junctional rhythm during RF ablation of slow pathway was variable, and Chinushi et al (7) reported that the appearance followed by a slowing and/or disappearance of repetitive ventricular responses during RF application was consistent with successful RF ablation in RVOT VT. We experienced the similar responses in our cases, so a slowing and/or disappearance of repetitive ventricular response during RF application might be another marker of successful ablation, but we need further studies with a larger number of patients.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Repetitive Ventricular Responses Induced by Radiofrequency Energy Application for Idiopathic Left Ventricular Tachycardia

et al. 2010

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In radiofrequency (RF) ablation for idiopathic left ventricular tachycardia (ILVT), the termination of tachycardia during RF ablation is considered a hallmark of success. However, in cases of patients with difficulty of induction of ventricular tachycardia (VT), the evaluation of procedural success can be problematic. We have observed thermal responses reflected as ventricular rhythm change to RF energy delivered on sinus rhythm for ILVT. We therefore describe the significance of repetitive ventricular responses. The study subjects were 11 ILVT patients for whom RF energy was delivered during sinus rhythm because of difficulty in re-induction of tachycardia. During each energy delivery, we focused on the occurrence of repetitive ventricular responses especially exhibiting a similar morphology to clinical VT. The repetitive ventricular responses were noted in 10 of 11 patients. Two patients received a second procedure due to the recurrence of ILVT. The mean follow-up period was 36.2±12.8 months. The clinical course of the remaining patients was favorable and without recurrence of ILVT. Based on the favorable clinical outcomes, ablation-induced repetitive ventricular responses with similar QRS morphology to clinical ILVT are useful markers for selecting an ablation site and could be used as an additional mapping method, termed as "thermal mapping".

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“…Furthermore, the study conducted by Iakobishvili et al. [ 11 ] found that the higher amount and longer duration of junctional rhythm are correlated with complete SP elimination. The differences of the periprocedural parameters indicated that AVNRT characteristics and electrophysiological profile in patients with SP elimination might differ from that of the patients in whom only SP modification was achieved.…”

Section: Discussionmentioning

confidence: 99%

AH jump duration is associated with elimination of slow pathway during ablation of atrioventricular nodal reentrant tachycardia

Raharjo

Togatorop

Andriantoro

et al. 2020

Indian Pacing and Electrophysiology Journal

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Introduction Ablating the slow pathway (SP) is the superior treatment for atrioventricular nodal reentrant tachycardia (AVNRT) with a low complication rate. However, the ablation of the SP could result in either complete elimination or modification of the SP. We aimed to investigate whether the duration of AH jump pre-ablation associated with the outcome of elimination of SP. Methods We included 56 patients with typical AVNRT (slow-fast), 20 males and 36 females, aged 44.2 ± 15.1 years. Slow pathway ablation was performed using classical approach. Univariate and multivariate analysis was performed for potential predictors of SP elimination. Results Typical AVNRT was inducible in all patients. Post-ablation, non-inducibility of AVNRT was obtained in all 56 (100%) patients, with SP elimination in 33 (61%) patients and SP modification in 23 (39%) patients. Patients with SP elimination had significantly longer AH jump than patients with SP modification. Cox regression analysis showed that AH jump duration was the independent predictor of SP elimination, in which every 20 ms increase in AH jump duration was associated with 1.30 higher rate of SP elimination. Furthermore, ROC curve analysis indicated that the AH jump duration of ≥100 ms had 6.14 times higher probability for complete elimination of the SP with a sensitivity of 79%, specificity of 70%, PPV of 79% and NPV of 70%. Conclusions AH jump duration pre-ablation is associated with complete elimination of slow pathway during AVNRT ablation.

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

Abstract: 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.

Cited by 21 publications

References 19 publications

Newly created animal model of human postoperative junctional ectopic tachycardia

Newly created animal model of human postoperative junctional ectopic tachycardia

The Significance of Repetitive Ventricular Responses Induced by Radiofrequency Energy Application for Idiopathic Left Ventricular Tachycardia

AH jump duration is associated with elimination of slow pathway during ablation of atrioventricular nodal reentrant tachycardia

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