Incidence and Clinical Significance of Junctional Rhythm Remaining After Termination of Radiofrequency Current Delivery in Patients With Atrioventricular Nodal Reentrant Tachycardia

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概要

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• The aim of this study was to elucidate the electrophysiologic characterstics and clinical significance of the accelerated junctional rhythm (JR) that remains after termination of radiofrequency (RF) current delivery during catheter ablation (CA) for atrioventricular nodal reentrant tachucardia (AVNRT). Fifty consecutive patients with AVNRT(21M, 29F, age 48 years)underwent RF-CA targeting the slow pathway. JR occurred ar 124 out of a total of 236 ablation sites (53%) during the RF delivery. With 15 RF deliveries (6.4%, n=10), JR remained after termination of the RF delivery (Post-JR). The mean cycle length of the Post-JR immediately after termination of the RF delivery was 639±124ms and its duration was widely distributed from 3s to more than 1h. The post-JR exhibited a spontaneous rate deceleration and overdrive suppression by rapid atrial pacing. The JR during the RF delivery followed by post-JR had a greater time span in which the JR appeared, compared with that without Post-JR. The Post-JR had less sensitivity (18 vs 96%), but greater specificity (97 vs 59%) and a positive predictive value (60 vs 39%) in predicting successful ablation compared with JR seen only during the RF delivery. It is concluded that the presence of Post-JR might be a reflection of the intence effect of RF energy on the nodal or peri-nodal tissue.

• 社団法人日本循環器学会の論文
• 1999-10-20

著者

• Kobayashi Yoshinori

  First Department of Internal Medicine, Nippon Medical School

• Hayakawa Hirokazu

  First Department of Internal Medicine, Nippon Medical School

• Takano Teruo

  First Department of Internal Medicine, Nippon Medical School

• Miyauchi Yasushi

  1st Department Of Internal Medicine Nippon Medical School

• Hayakawa Hirokazu

  The First Department Of Medicine Nippon Medical School

• Hayakawa Hirokazu

  Internal Medicine Department Of Cardiology Nippon Medical School

• Hayakawa Hirokazu

  The First Department Of Internal Medicine Nippon Medical School

• Atarashi Hirotsugu

  First Department of Internal Medicine, Nippon Medical School

• Takano Teruo

  First Department Of Internal Medicine Nippon Medical School

• Miyauchi Yasushi

  First Department of Internal Medicine, Nippon Medical School

• Atarashi Hirotsugu

  First Department Of Internal Medicine Nippon Medical School

• Kawaguchi Naomi

  Department Of First Internal Medicine Nippon Medical School

• Kusama Yoshiki

  Nippon Medical School

• Hayakawa Hirokazu

  First Department Of Internal Medicine Nippon Medical School

• Hayakawa Hirokazu

  The 1st Department Of Internal Medicine Nippon Medical School

• Kawaguchi Naomi

  First Department of Internal Medicine, Nippon Medical School

• Atarashi Hirotsugu

  The First Department Of Internal Medicine Nippon Medical

• Atarashi Hirotsugu

  Department Of Internal Medicine And Cardiology Nippon Medical School Tama-nagayama Hospital

• Honma Hiroshi

  Department Of Physiological Laboratory Nippon Medical School

• Kobayashi Yoshinori

  First Department Of Internal Medicine Nippon Medical School

• Hayashi Hiromitsu

  Department Of Radiology Graduate School Of Radiology Nippon Medical School

• Honma Hiroshi

  Division Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicine

• Hayakawa Hirokazu

  First Dept Of Internal Medicine Nippon Medical School

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