Document Detail

Impaired subsidiary pacemaker function in patients with a right bundle branch block created prior to complete catheter ablation of the AV junction.
MedLine Citation:
PMID:  8472717     Owner:  NLM     Status:  MEDLINE    
The impact of a right bundle branch block (RBBB), inadvertently created prior to complete ablation of the atrioventricular (AV) junction, on the intrinsic subsidiary pacemaker function was investigated. In 31 patients suffering from intractable supraventricular tachyarrhythmia, catheter ablation of the AV junction was performed using direct current (n = 13) or radiofrequency (n = 18) energy. In 16/31 patients a RBBB was created prior to complete AV ablation. Subsidiary pacemaker function was evaluated after a mean period of 5 months. Following 5 min of ventricular pacing (70 beats.min-1) escape interval and spontaneous heart rate were measured. In patients with a RBBB there was a trend towards a longer escape interval (2979 +/- 2559 vs 1867 +/- 1254 ms, P = ns) and a significantly lower intrinsic heart rate (38 +/- 14 vs 47 +/- 8 beats.min-1, P < 0.05). Pacemaker dependency was only observed among patients with a RBBB (4/16 vs 0/15, P < 0.05). HV intervals were shorter in those energy discharges resulting in a RBBB as compared to those inducing a complete heart block (52 +/- 8 vs 66 +/- 6 ms, P < 0.05). Creation of a RBBB prior to complete ablation of the AV junction results in impaired intrinsic subsidiary pacemaker function; the most proximal catheter position should be carefully sought to minimize the risk of pacemaker dependency.
G Kreiner; G Heinz; P Siostrzonek; A Stümpflen; T Binder; H D Gössinger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  14     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-20     Completed Date:  1993-05-20     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  526-9     Citation Subset:  IM    
2nd Department of Medicine/Cardiology, University of Vienna, Austria.
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MeSH Terms
Atrial Fibrillation / surgery
Atrioventricular Node / surgery*
Bundle-Branch Block / epidemiology,  etiology*,  physiopathology
Cardiac Pacing, Artificial / methods
Catheter Ablation / adverse effects*,  methods
Follow-Up Studies
Heart Conduction System / physiopathology*
Middle Aged
Pacemaker, Artificial
Time Factors

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

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