Evaluation of the Quantity and Duration of Junctional Rhythm during Successful Radiofrequency Ablation among Patients with Atrioventricular Nodal Re-Entry Tachycardia

Abstract

Objectives: To evaluate the quantity and duration of junctional rhythm during radiofrequency ablation among atrioventricular nodal reentry tachycardia (AVRNT) patients.

Methodology: A Cross sectional study was conducted at Punjab Institute of cardiology from May – July, 2022. Ablations of slow pathway were executed on 50 patients who fulfilled the inclusion criteria using ablation catheters of 4-mm tip. Power output was kept between 35- 40 Watt with a temperature control at 60 °C depending upon the occurrence of junctional rhythm. The target end points of radio frequency ablation (RFA) were inability to either induce or spontaneously demonstrate clinical tachycardia. Presence of more than one atrio-ventricular (AV) nodal echo beat was the criteria to continue further ablations as it was considered indicator residual slow pathway. Data was entered in SPSS software version 21.0 and were presented as mean ± SD were used.

Results: The mean age of the patients was 36.50 ± 7.129 years. Ablation power was titrated between 35-40 watts (Mean 39.6 ± 1.37). The average amount of junctional beats in each patient was 57.34 ± 9.71 (73-38) with mean duration of junctional rhythm was 29.20 ± 3.47 sec. Successful ablation mean was 54.25 + 8.45 as compared to unsuccessful attempts of 44.32 ± 5.77 and was statistically significant (p<0.001).

Conclusion: The study concluded that RFA had high success rate and a low recurrence rate with less complication. Junctional rhythm is a sensitive predictor of successful ablation and is a safe and effective way of permanent termination of AVNRT.