JAPANESE CIRCULATION JOURNAL
Online ISSN : 1347-4839
Print ISSN : 0047-1828
ISSN-L : 0047-1828
Clinical Study
Incidence and Clinical Significance of Junctional Rhythm Remaining After Termination of Radiofrequency Current Delivery in Patients With Atrioventricular Nodal Reentrant Tachycardia
Naomi KawaguchiYoshinori KobayashiYasushi MiyauchiHirotsugu AtarashiTeruo TakanoHirokazu Hayakawa
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1999 Volume 63 Issue 11 Pages 865-872

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Abstract

The aim of this study was to elucidate the electrophysiologic characteristics and clinical significance of the accelerated junctional rhythm (JR) that remains after termination of radiofrequency (RF) current delivery during catheter ablation (CA) for atrioventricular nodal reentrant tachycardia (AVNRT). Fifty consecutive patients with AVNRT (21M, 29F, age 48 years) underwent RF-CA targeting the slow pathway. JR occurred at 124 out of a total of 236 ablation sites (53%) during the RF delivery. With 15 RF deliveries (6.4%, n=10), JR remained after termination of the RF delivery (Post-JR). The mean cycle length of the Post-JR immediately after termination of the RF delivery was 639±124 ms and its duration was widely distributed from 3 s to more than 1 h. The Post-JR exhibited a spontaneous rate deceleration and overdrive suppression by rapid atrial pacing. The JR during the RF delivery followed by Post-JR had a greater time span in which the JR appeared, compared with that without Post-JR. The Post-JR had less sensitivity(18 vs 96%), but greater specificity (97 vs 59%) and a positive predictive value (60 vs 39%) in predicting successful ablation compared with JR seen only during the RF delivery. It is concluded that the presence of Post-JR might be a reflection of the intense effect of RF energy on the nodal or peri-nodal tissue. (Jpn Circ J 1999; 63: 865 - 872)

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© 1999 THE JAPANESE CIRCULATION SOCIETY
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