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Mau-song Chang - One of the best experts on this subject based on the ideXlab platform.
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Absence of Junctional Rhythm during successful slow-pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P
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absence of Junctional Rhythm during successful slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P<0.001). The fast-slow form of tachycardia was more common in patients without than in those wit...
Ming Hsiung Hsieh - One of the best experts on this subject based on the ideXlab platform.
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Electrophysiological characteristics of Junctional Rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia.
Pacing and Clinical Electrophysiology, 2005Co-Authors: Shih Huang Lee, Chern-en Chiang, Ming Hsiung Hsieh, Ching Tai Tai, Yi Jen Chen, Pi Chang Lee, Jun Jack Cheng, Kow Chang Ueng, Chin Feng Tsai, Chuen Wang ChiouAbstract:Background: Junctional Rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HA S V T ) and JR (HA J R ) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HA J R was significantly shorter than the HA S V T (57 ′ 24 vs 68 ′ 21 ms, P < 0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HAIR was also significantly shorter than the HA S V T (145 ′ 27 vs 168 ′ 29 ms, P= 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7(100%)patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P < 0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs ½7, P < 0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.
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Absence of Junctional Rhythm during successful slow-pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P
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absence of Junctional Rhythm during successful slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P<0.001). The fast-slow form of tachycardia was more common in patients without than in those wit...
Amos Katz - One of the best experts on this subject based on the ideXlab platform.
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patterns of accelerated Junctional Rhythm during slow pathway catheter ablation for atrioventricular nodal reentrant tachycardia temperature dependence prognostic value and insights into the nature of the slow pathway
Journal of Cardiovascular Electrophysiology, 2000Co-Authors: Alan B Wagshal, Eugene Crystal, Amos KatzAbstract:Slow Pathway Accelerated Junctional Rhythm. Introduction: Although accelerated Junctional Rhythm (AJR) is a knuwn marker for successful slow pathway (SP) ablation sites. AJR may just be a regional effect of the anisotropic conduction properties of this area of the heart. We believe that detailed assessment of the AJR might provide insight into the SP specificity of this AJR and perhaps the nature of the SP itself. Methods and Results: Our ablation protocol consisted of 30-second, 70°C temperature-controlled ablation pulses with assessment after each pulse. Serial booster ablations were performed at the original successful site and at least 2 to 3 nearby sites to assess for residual AJR after the procedure in 50 consecutive SP ablations. We defined three distinct patterns of AJR: continuous AJR that persisted until the end of energy delivery (group 1, 25 patients); alternating or “stuttering” AJR that persisted throughout energy delivery (group II, 9 patients); and AJR that ended abruptly during energy delivery (group III, 16 patients). Mean ablation temperatures in the three groups was 57°± 5°C, 54°± 5°C, and 63°± 5°C, respectively (P = 0.0002 for groups I and II vs group III). Ten of 34 (29%) patients in groups I and II (“low-temperature ablation”) exhibited residual SP (jump and/or single echo heats) despite tachycardia noninducibility, and 25 of 34 (73%) patients had residual AJR during the booster ablations, but neither of these was seen in any group III patients. Conclusion: Ablation temperature correlates with the pattern of AJR produced during SP ablation. That higher temperature lesions simultaneously abolish all SP activity as well as the focus of AJR suggests that this AJR is specific for the SP and is not a nonspecific regional effect.
Yi Jen Chen - One of the best experts on this subject based on the ideXlab platform.
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Electrophysiological characteristics of Junctional Rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia.
Pacing and Clinical Electrophysiology, 2005Co-Authors: Shih Huang Lee, Chern-en Chiang, Ming Hsiung Hsieh, Ching Tai Tai, Yi Jen Chen, Pi Chang Lee, Jun Jack Cheng, Kow Chang Ueng, Chin Feng Tsai, Chuen Wang ChiouAbstract:Background: Junctional Rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HA S V T ) and JR (HA J R ) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HA J R was significantly shorter than the HA S V T (57 ′ 24 vs 68 ′ 21 ms, P < 0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HAIR was also significantly shorter than the HA S V T (145 ′ 27 vs 168 ′ 29 ms, P= 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7(100%)patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P < 0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs ½7, P < 0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.
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Absence of Junctional Rhythm during successful slow-pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P
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absence of Junctional Rhythm during successful slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P<0.001). The fast-slow form of tachycardia was more common in patients without than in those wit...
Ching Tai Tai - One of the best experts on this subject based on the ideXlab platform.
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Electrophysiological characteristics of Junctional Rhythm during ablation of the slow pathway in different types of atrioventricular nodal reentrant tachycardia.
Pacing and Clinical Electrophysiology, 2005Co-Authors: Shih Huang Lee, Chern-en Chiang, Ming Hsiung Hsieh, Ching Tai Tai, Yi Jen Chen, Pi Chang Lee, Jun Jack Cheng, Kow Chang Ueng, Chin Feng Tsai, Chuen Wang ChiouAbstract:Background: Junctional Rhythm (JR) is commonly observed during radiofrequency (RF) ablation of the slow pathway for atrioventricular (AV) nodal reentrant tachycardia. However, the atrial activation pattern and conduction time from the His-bundle region to the atria recorded during JR in different types of AV nodal reentrant tachycardia have not been fully defined. Methods: Forty-five patients who underwent RF ablation of the slow pathway for AV nodal reentrant tachycardia were included; 27 patients with slow-fast, 11 patients with slow-intermediate, and 7 patients with fast-slow AV nodal reentrant tachycardia. The atrial activation pattern and HA interval (from the His-bundle potential to the atrial recording of the high right atrial catheter) during AV nodal reentrant tachycardia (HA S V T ) and JR (HA J R ) were analyzed. Results: In all patients with slow-fast AV nodal reentrant tachycardia, the atrial activation sequence recorded during JR was similar to that of the retrograde fast pathway, and transient retrograde conduction block during JR was found in 1 (4%) patient. The HA J R was significantly shorter than the HA S V T (57 ′ 24 vs 68 ′ 21 ms, P < 0.01). In patients with slow-intermediate AV nodal reentrant tachycardia, the atrial activation sequence of the JR was similar to that of the retrograde fast pathway in 5 (45%), and to that of the retrograde intermediate pathway in 6 (55%) patients. Transient retrograde conduction block during JR was noted in 1 (9%) patient. The HAIR was also significantly shorter than the HA S V T (145 ′ 27 vs 168 ′ 29 ms, P= 0.014). In patients with fast-slow AV nodal reentrant tachycardia, retrograde conduction with block during JR was noted in 7(100%)patients. The incidence of retrograde conduction block during JR was higher in fast-slow AV nodal reentrant tachycardia than slow-fast (7/7 vs 1/11, P < 0.01) and slow-intermediate AV nodal reentrant tachycardia (7/7 vs ½7, P < 0.01). Conclusions: In patients with slow-fast and slow-intermediate AV nodal reentrant tachycardia, the JR during ablation of the slow pathway conducted to the atria through the fast or intermediate pathway. In patients with fast-slow AV nodal reentrant tachycardia, there was no retrograde conduction during JR. These findings suggested there were different characteristics of the JR during slow-pathway ablation of different types of AV nodal reentrant tachycardia.
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Absence of Junctional Rhythm during successful slow-pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P
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absence of Junctional Rhythm during successful slow pathway ablation in patients with atrioventricular nodal reentrant tachycardia
Circulation, 1998Co-Authors: Ming Hsiung Hsieh, Shih-ann Chen, Ching Tai Tai, Yi Jen Chen, Mau-song ChangAbstract:Background—The presence of Junctional Rhythm has been considered to be a sensitive marker of successful slow-pathway ablation. However, in rare cases, Junctional Rhythm was absent despite multiple radiofrequency applications delivered over a large area in the Koch’s triangle, and successful ablation was achieved in the absence of a Junctional Rhythm. Methods and Results—This study included 353 patients with AV nodal reentrant tachycardia (143 men and 210 women; mean age, 50±17 years) who underwent catheter ablation of the slow pathway. Combined anatomic and electrogram approaches were used to guide ablation. Inducibility of AV nodal reentrant tachycardia was assessed after each application of radiofrequency energy. Successful sites were located in the posterior area in 18 (90%) of 20 patients without Junctional Rhythm during slow-pathway ablation compared with 200 (60%) of 333 patients with Junctional Rhythm (P<0.001). The fast-slow form of tachycardia was more common in patients without than in those wit...
