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Bimodal RR Interval Distribution in Chronic Atrial Fibrillation:
Author(s) -
TEBBENJOHANNS JÜRGEN,
SCHUMACHER BURGHARD,
KORTE THOMAS,
NIEHAUS MICHAEL,
PFEIFFER DIETRICH
Publication year - 2000
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2000.tb00001.x
Subject(s) - medicine , atrial fibrillation , cardiology , ablation , catheter ablation , atrioventricular node , nodal , radiofrequency ablation , tachycardia
Bimodal RR Interval Distribution, Introduction: Radiofrequency (RF) catheter modification of the AV node hi patients with atrial fibrillation (AF) is limited by an unpredictable decrease of the ventricular rate and a wish incidence of permanent AV block, A bimodal RR histogram has been suggested to serve as a predictor for successful outcome but the corresponding AV node properties have never been characterized, We hypothesized that a bimodal histogram indicates dual AV nodal physiology and predicts a better outcome after AV node modification in chronic AF. Methods and Results: Thirty‐seven patients were prospectively subdivided into two groups according to the RR histogram of 24‐hour ECC monitoring, Before to RF ablation, internal cardioversion and programmed stimulation were performed, Among the 22 patients (group I) with a bimodal RR histogram, dual AV nodal physiology was found in 17 (779f) patients, Ablation significantly decreased ventricular rate with loss of the peak of short RR cycles after ablation (mean and maximal ventricular rates: 32% and 35% rate reduction, respectively; P < 0,01), In 15 patients with a unimodal RR histogram (group II), dual AV nodal physiology was found in 2 (13%), and rate reductions were 16% and 17%, respectively, At 6 months, 3 (14%) patients in group 1 and 6 (40%) in group II underwent elective AV nodal ablation with pacemaker implantation due to intolerable rapid ventricular response to AF. Conclusion: Bimodal RR interval distribution during chronic AF suggests the presence of dual AV nodal physiology and predicts a better outcome of RF ablation of the posterior atrionocdal input.