Just How Stable Are Escape Rhythms after Atrioventricular Junction Ablation?

Arora, Rishi; Spatz, Erica S.; Vijayaraman, Pugazhendhi; Rosengarten, M; Gross, Jay N.; Kim, Soo Jeong; Fisher, John D.; Ferrick, Kevin J.

doi:10.1111/j.1540-8159.2010.02756.x

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…There was no follow‐up analysis performed. Arora et al 20 studied 96 patients after AV‐junctional ablation. They found 79% having an AV‐junctional rhythm of 30 bpm and above, 72% being stable over time.…”

Section: Discussionmentioning

confidence: 99%

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AV‐node isolation as an alternative to AV‐node ablation in patients undergoing pace & ablate strategy

Lemke

Hamriti

Braun

et al. 2022

Cardiovasc electrophysiol

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Introduction Atrioventricular (AV)‐node ablation (AVNA) is a common therapy option for rate control strategy of permanent atrial fibrillation (AF). We hypothesized that isolation of the AV nodal isolation (AVNI) is associated with a more frequent preservation of an adequate escape rhythm compared to AVNA. Methods This retrospective study included 20 patients with therapy‐refractory AF being treated with AVNI and 40 historical AVNA‐controls. In AVNI the AV‐node region was mapped using a 3D mapping system. Ablation was performed around the previously mapped HIS‐cloud regions isolating the atrium from the AV‐node. In the AVNI group, ablation was performed with irrigated tip ablation catheter in all cases. The two approaches were compared regarding rate of escape rhythm, delta QRS, and procedural data. Results The number of patients with adequate escape rhythm in AVNI was significantly superior to AVNA immediately postoperative (90% vs. 40%, p < 0.01) and during follow‐up (77% vs. 36%, p < 0.05). The median change in QRS width was 0 ms in AVNI versus +26 ms in AVNA (p < 0.01). Thirty percent new bundle branch blocks in AVNA were observed compared to 0% in AVNI (p < 0.01). In the AVNI group, fluoroscopy time and total dose area product were significantly lower (p < 0.01). Conclusion The present study suggests that AV‐node isolation using 3D navigation mapping system is a feasible and effective alternative to conventional AVNA. The precise application of radiofrequency lesions preserves a stable AV‐junctional rhythm.

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Section: Discussionmentioning

confidence: 99%

“…There was no follow-up analysis performed. Arora et al 20 [24][25][26] Huang et al 27 suggest a distance between HBP and AVN ablation site of at least 8 mm. With AVN isolation even a major safety zone can be discharged so this approach can be favorable for HBP.…”

Section: Discussionmentioning

confidence: 99%