May 29, 2000

Bimodal RR interval distribution in chronic atrial fibrillation: impact of dual atrioventricular nodal physiology on long-term rate control after catheter ablation of the posterior atrionodal input

Journal of Cardiovascular Electrophysiology
J TebbenjohannsD Pfeiffer

Abstract

Radiofrequency (RF) catheter modification of the AV node in patients with atrial fibrillation (AF) is limited by an unpredictable decrease of the ventricular rate and a high incidence of permanent AV block. A bimodal RR histogram has been suggested to serve as a predictor for successful outcome but the corresponding AV node properties have never been characterized. We hypothesized that a bimodal histogram indicates dual AV nodal physiology and predicts a better outcome after AV node modification in chronic AF. Thirty-seven patients were prospectively subdivided into two groups according to the RR histogram of 24-hour ECG monitoring. Before to RF ablation, internal cardioversion and programmed stimulation were performed. Among the 22 patients (group I) with a bimodal RR histogram, dual AV nodal physiology was found in 17 (77%) patients. Ablation significantly decreased ventricular rate with loss of the peak of short RR cycles after ablation (mean and maximal ventricular rates: 32% and 35% rate reduction, respectively; P < 0.01). In 15 patients with a unimodal RR histogram (group II), dual AV nodal physiology was found in 2 (13%), and rate reductions were 16% and 17%, respectively. At 6 months, 3 (14%) patients in group I and 6 (...Continue Reading

  • References
  • Citations

References

  • We're still populating references for this paper, please check back later.
  • References
  • Citations

Citations

  • This paper may not have been cited yet.

Mentioned in this Paper

Heart Block
Chronic Disease
Blastocyst Implantation, Natural
Cardiac Catheterization Procedures
Atrial Fibrillation
Atrioventricular Block
Holter Electrocardiography
Structure of Atrioventricular Node
Ventricular Function
NODAL gene

About this Paper

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.