Mar 1, 1993

Radiofrequency modification of atrioventricular conduction by selective ablation of the low posterior septal right atrium in a patient with atrial fibrillation and a rapid ventricular response

Pacing and Clinical Electrophysiology : PACE
R P FleckG K Feld


A case is presented of a 58-year-old woman with atrial fibrillation and uncontrolled ventricular responses up to 180 beats/min despite therapy with digoxin. Radiofrequency energy was applied to the low posteroseptal right atrium in an attempt to modify "slow fiber" conduction. This resulted in a decrease in ventricular rate from 125 to 50 beats/min. Follow-up Holter monitor demonstrated an average heart rate of 64 beats/min (range 43-112). On exercise tolerance test, the maximum heart rate was 126. Modification of the low posterosepta right atrium may prove to be an alternative to AV node or His bundle ablation and pacemaker implantation in patients with poorly controlled atrial fibrillation and rapid ventricular response. The mechanism by which this approach was effective may be ablation of slow conducting AV nodal fibers with a short refractory period.

Mentioned in this Paper

Blastocyst Implantation, Natural
Right Atrial Structure
Cardiopulmonary Exercise Test
Exercise Stress ECG Test
Atrial Fibrillation
Exercise Stress Test
Holter Electrocardiography
Refractory Period
Entire Right Atrium

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