Jun 20, 2001

Atrioventricular node modification in patients with chronic atrial fibrillation: role of morphology of RR interval variation

Circulation
S RokasS Stamatelopoulos

Abstract

This study evaluates the role of RR interval distribution pattern as an outcome predictor of radiofrequency (RF) modification of atrioventricular (AV) node in chronic atrial fibrillation (AF) and attempts to elucidate the likely mechanism of rate control. Sixty-five patients with chronic AF underwent AV node modification. The RR interval distribution pattern was derived from 24-hour ECG recordings obtained before and after the procedure. The preablation pattern was bimodal (B) in 36 patients (55%) and unimodal (U) in 29 patients (45%). After the modification procedure, the B pattern shifted to U (78%) or became modified B (22%). The mean number of RF pulses delivered and the fluoroscopy time were n=8+/-5 and 24+/-11 minutes, respectively, in patients with B pattern versus n=18+/-7 and 45+/-17 minutes in patients with U pattern (P<0.001 for both). The location of successful ablation was posteroseptal and lower midseptal in 26 patients (81%) with B pattern versus 2 (13%) with U pattern (P<0.001). Mean and maximal ventricular rates and heart rate at peak exercise were reduced after the procedure in both groups (P<0.001 for all). Long-term success rate, AV block incidence, and pacemaker implantation rate were 89%, 0%, and 8%, respe...Continue Reading

Mentioned in this Paper

Physiologic Pulse
Science of Morphology
Chronic Disease
Blastocyst Implantation, Natural
Cardiopulmonary Exercise Test
Fluoroscopy
Atrial Fibrillation
Atrioventricular Block
Cardiac Conduction System
Structure of Atrioventricular Node

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