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Initial and Long‐Term Evaluation of Escape Rhythm After Radiofrequency Ablation of the AV Junction in 50 Patients
Author(s) -
PIOT OLIVIER,
SEBAG CLAUDE,
LAVERGNE THOMAS,
OLLITRAULT JACKY,
JOHNSON NICOLAS,
DINANIAN SYLVIE,
HEUZEY JEANYVES,
GUIZE LOUIS,
MOTTÉ GILBERT
Publication year - 1996
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 - 10.1111/j.1540-8159.1996.tb03267.x
Subject(s) - medicine , term (time) , rhythm , ablation , radiofrequency ablation , cardiology , physics , quantum mechanics
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.