Document Detail

Atrial rhythm after atrioventricular junctional ablation.
MedLine Citation:
PMID:  8960584     Owner:  NLM     Status:  MEDLINE    
Atrioventricular (AV) junctional ablation followed by pacemaker implantation is an established treatment for patients with refractory paroxysmal atrial arrhythmias. The stability of the underlying atrial rhythm after AV junctional ablation is unknown. This study evaluates the atrial rhythm after AV junctional ablation in 49 patients with medically refractory atrial arrhythmias. The group included 25 men and 24 women, of whom 36 had known structural heart disease. Paroxysmal atrial fibrillation was the primary rhythm disturbance in 41 patients, whereas 8 manifested either atrial tachycardias or atrial flutter. All patients had failed therapy with > or = 1 antiarrhythmic drug. Chronic pacing modes were DDIR or DDDR, with mode switching in 15 patients and VVIR in 34 patients. After AV junctional ablation, chronic antiarrhythmic drug therapy was prescribed in only 4 patients (8%). Routine electrocardiograms (ECGs; 6.5 +/- 6.1/patient) during long-term follow-up (18.6 +/- 15.6 months) showed that 7 patients (14%) had an atrial arrhythmia detected on all ECGs, 30 patients (61%) had sinus or atrial-paced rhythms on all recordings, and 12 patients (25%) had both atrial arrhythmias and sinus rhythm documented. Sinus or an atrial-paced rhythm was present on the last available ECG in 33 of 49 patients (67%). Pacing mode was not a predictor of continued sinus rhythm. In conclusion, most patients with a history of paroxysmal atrial tachyarrhythmias will not convert to chronic atrial arrhythmias after AV junctional ablation, even in the absence of antiarrhythmic drug therapy. Use of dual-chamber pacing modes will allow maintenance of at least intermittent atrial function in these patients.
M A Mitchell; S J Ackerman; S Nath; D E Haines; J P DiMarco
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-10     Completed Date:  1997-01-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1251-4     Citation Subset:  AIM; IM    
Cardiovascular Division, Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
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MeSH Terms
Aged, 80 and over
Atrial Function / physiology*
Atrioventricular Node / physiology,  surgery*
Cardiac Pacing, Artificial
Follow-Up Studies
Prostheses and Implants
Tachycardia, Paroxysmal / diagnosis,  surgery*

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