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- Title
Initial and Long-Term Evaluation of Escape Rhythm After Radiofrequency Ablation of the AV Junction in 50 Patients.
- Authors
Piot, Oliver; Sebag, Claude; Lavergne, Thomas; Ollitrault, Jacky; Johnson, Nicolas; Dinanian, Sylvie; Le Heuzey, Jean-Yves; Guize, Louis; Motté1, Gilbert
- Abstract
Between 1986 and 1994, 50 patients (mean age 63 ± 13 years), 25 of whom had organic heart disease and presenting with atrial arrhythmias refractory to 5.6 ±1.6 antiarrhythmic drugs, underwent radiofrequency ablation (5 ± 3 pulses by procedure; duration of pulses 50.5 ± 32 s) of the proximal AV junction to create complete and permanent AV block. The escape rhythm was studied immediately after the procedure and during long-term follow-up. Immediately after the procedure, an escape rhythm was observed in 80% of the patients (junctional in 92%). Over a mean follow-up of 36 ± 16 months in 47 patients (2 patients died before assessment of escape rhythm and 1 was lost to follow-up), an escape rhythm was present in 39 patients (83%) and absent in the remaining 8 (17%). The only significant difference between the two groups was the initial presence of an escape rhythm (P = 0.008). However, three patients with an initial escape rhythm had none during long-term follow-up. The initial presence of an escape rhythm as a predictive factor of its presence during follow-up had a sensitivity of 87%, specificity of 63%, positive predictive value of 92%, and negative predictive value of 50%. Thus, the absence of an escape rhythm during long-term follow-up causing pacemaker dependency was noted in 1 of 6 patients. This represents a limitation to this palliative treatment, which should be reserved for patients suffering from supraventricular tachycardias refractory to other treatments.
- Subjects
CARDIAC patients; ATRIAL arrhythmias; ARRHYTHMIA; MYOCARDIAL depressants; ATRIOVENTRICULAR node; CARDIAC pacemakers
- Publication
Pacing & Clinical Electrophysiology, 1996, Vol 19, Issue 11, p1988
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.1996.tb03267.x