Junctional rhythm occurring during AV nodal reentrant tachycardia ablation, is it different among Egyptians?

Abstract

Introduction: Radio frequency ablation of the slow pathway has become first-line therapy for the elimination of AV nodal reentrant tachycardia (AVNRT). Slow pathway ablation is guided by a combination of fluoroscopic landmarks, electrogram morphology, and the induction of accelerated junctional rhythm (JR) during the application of radiofrequency energy. Although JR occurs usually during slow pathway ablation of AVNRT, the pattern of JR has not been adequately studied.13 Aim of the study: To investigate in detail the characteristics of junctional rhythm occurring during radiofrequency ablation of atrioventricular nodal reentrant tachycardia AVNRT among Egyptians. Methods: This study included 30 patients who underwent electrophysiological study for narrow complex supraventricular regular tachycardia which revealed to be AVNRT. Results: Thirty (100%) patients showed induction of junctional rhythm at the successful ablation sites. JR was a very sensitive predictor of successful ablation but not so specific with specificity of 60%. Sex patterns of JR were observed. The most common pattern of JR was sinus–junctional–junctional (SJJ) while sinus–junctional-block (SJB) was the least. The most specific pattern for effective ablation was junctional–junctional–junctional (JJJ), while intermittent burst was the least. P value is 0.001 i.e. highly significant. Conclusion: Junctional rhythm is a sensitive predictor of successful ablation. The pattern of JR is a useful predictor of successful ablation. Egyptian population has distinctive patterns of JR during AVNRT ablation.

Keywords

• AVNRT
• Junctional rhythm
• Ablation