Document Detail


Effects of ablation, digitalis, and beta-blocker on dual atrioventricular nodal pathways and conduction during atrial fibrillation.
MedLine Citation:
PMID:  15485437     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Modification of AV nodal conduction by radiofrequency ablation (RFA) results in a variable reduction in heart rate during atrial fibrillation (AF). Using AF induced in patients with dual AV nodal pathways as a model, we tested the effect of additional treatment with digitalis (ouabain) and beta-blocker (esmolol). METHODS AND RESULTS: Ten patients were randomized to control (group I) and studied only before ablation. AF was induced in 30 patients before and after slow pathway ablation (group II). Mean ventricular cycle lengths (AF CLmean) were recorded. Slow pathway conduction was eliminated after ablation in 10 patients (group IIA), whereas slow pathway conduction was still present in 20 patients (group IIB). Compared to pre-RFA there was a 10% increase in AF CLmean post-RFA (P < 0.01). During isoproterenol infusion the increase was 8% (P = NS). Adding digitalis and beta-blocker during isoproterenol infusion increased AF CLmean by 75% (95% in group IIA) compared to 36% in group I (P < 0.001 II vs I). CONCLUSION: Slow pathway ablation reduces ventricular rate during AF. Addition of digitalis and beta-blocker during isoproterenol infusion significantly decreases ventricular rate after ablation compared to the control group. The finding suggests that beta-blocker has significant effects on fast AV nodal pathway conduction during induced AF with isoproterenol infusion.
Authors:
Finn Hegbom; Otto M Orning; Magnus Heldal; Knut Gjesdal
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  15     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-15     Completed Date:  2004-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1141-6     Citation Subset:  IM    
Affiliation:
Heart & Lung Center, Ullevål University Hospital, Oslo, Norway. finn.hegbom@IOKS.uio.no
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Atrial Fibrillation / chemically induced,  physiopathology*,  therapy*
Atrioventricular Node / drug effects,  physiology*
Catheter Ablation*
Digitalis Glycosides / therapeutic use*
Female
Heart Conduction System / drug effects,  physiology*
Humans
Isoproterenol
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Digitalis Glycosides; 7683-59-2/Isoproterenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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