Document Detail


Changes in escape rhythms several years after radiofrequency ablation of the atrioventricular junction combined with pacemaker implantation.
MedLine Citation:
PMID:  17117753     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Escape rhythm is thought to play a considerable role in protection against adverse outcome due to pacemaker malfunction. We studied the escape rhythms in 32 patients with supraventricular tachyarrhythmia refractory to medical therapy who underwent radiofrequency ablation of the atrioventricular junction combined with implantation of a pacemaker. METHODS AND RESULTS: We performed the escape rhythm analysis immediately and 2.6 +/- 1.9 years after the radiofrequency ablation by decreasing the pacing rate. In the initial study, escape rhythms (41 +/- 8 beats/min) were documented in 20 patients (63%). Non-cardiac death occurred in 3 patients with escape rhythm, and cardiac death occurred in I patient without escape rhythm. In the follow-up study, escape rhythms were detected in 22 of 28 patients (79%). Escape rhythm had developed in 6 (55%) of 11 patients who were without escape rhythm initially, while escape rhythm disappeared in 1 of 17 (5.9%) patients who had escape rhythm initially. The changes in escape rhythm were not related to QRS width of the intrinsic beat. There was no correlation between the number of radiofrequency applications or the ratio between atrial and ventricular electrocardiogram voltages of radiofrequency applications and the development of escape rhythms. CONCLUSIONS: The present long-term follow-up study demonstrated that the emergence of an escape rhythm increased several years after ablation, but was unrelated to procedural factors. There are, however, certain patients in whom the disappearance of escape rhythms occur. The evaluation of escape rhythms is thus necessary to determine the risk associated with pacemaker failure.
Authors:
Hiroshi Kawamura; Kazuyoshi Hina; Shozo Kusachi; Kohichiro Iwasaki; Keizo Yamamoto; Takashi Murakami; Masaaki Murakami; Mutsumi Iwamoto; Shigeshi Kamikawa; Yasushi Shiratori
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  61     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-11-22     Completed Date:  2007-06-19     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  531-6     Citation Subset:  IM    
Affiliation:
Department of Medicine and Medical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Atrial Fibrillation / etiology,  physiopathology,  therapy
Atrioventricular Node / physiopathology*,  surgery*
Bradycardia / complications,  physiopathology,  therapy
Catheter Ablation* / adverse effects
Combined Modality Therapy
Electrocardiography
Female
Follow-Up Studies
Heart Rate*
Humans
Male
Middle Aged
Pacemaker, Artificial*
Recurrence
Reoperation
Research Design
Sick Sinus Syndrome / complications,  physiopathology,  therapy
Tachycardia / complications,  physiopathology,  therapy
Tachycardia, Supraventricular / physiopathology*,  therapy*
Treatment Outcome

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