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Transient Proarrhythmic State Following Atrioventricular Junctional Radiofrequency Ablation
Author(s) -
NOWINSKI KAROLINA,
GADLER FREDRIK,
JENSENURSTAD MATS,
BERGFELDT LENNART
Publication year - 2002
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2002.00291.x
Subject(s) - medicine , cardiology , qrs complex , ablation , junctional rhythm , repolarization , electrocardiography , radiofrequency ablation , anesthesia , electrophysiology
NOWINSKI, K., et al. : Transient Proarrhythmic State Following Atrioventricular Junctional Radiofre‐quency Ablation. This study was designed to prospectively assess ventricular de‐ and repolarization by the QRS, QT, and JT intervals, and their dispersion in the 12‐lead ECG during right ventricular pacing at 60, 70, and 80 beats/min during the first month after AV junctional RF ablation. Previous reports have found early polymorphic ventricular arrhythmia after RF AV junctional ablation. Our hypothesis was that there is a proarrhythmic state following this procedure, which depends on the paced rate and time after ablation. The analysis of the immediate changes was based on 17 patients (10 men) with a mean age of 64 years (SD 14) (range 38–82 years). A 12‐lead ECG was recorded during right ventricular pacing at 60, 70, and 80 beats/min within 24 hours (day 1), between 24 and 48 hours (day 2), and 1 week after ablation (day 7). For analysis of changes beyond 1 week, 13 additional patients with a mean age of 73 years (SD 8) (range 62–90 years) were analyzed on days 1, 7, and 30. All intervals were measured with a digitizing table. The mean QRS duration shortened by 2.4% at 60 beats/min ( P < 0.01 ), and the mean QT and JT intervals shortened by 5–7% between days 1 and 7 ( P < 0.001 ). The mean QT was 9% shorter and the mean JT interval was 13% shorter at 80 compared to 60 beats/min on day 1 ( P < 0.001 ). QT dispersion was reduced by 13% when the stimulation rate was increased from 60 to 80 beats/min on day 1 ( P < 0.05 ). There were no significant changes beyond the first week. The study results point to the induction of a proarrhythmic state immediately after AV junctional RF ablation resolving during the first week. Repolarization shortened gradually between 80 and 60 beats/min to an extent that is suggestive of a clinically important antiarrhythmic effect at the higher rate, which was supported also by clinical experience.