Junctional rhythm quantity and duration during slow pathway radiofrequency ablation in patients with atrioventricular nodal re-entry supraventricular tachycardia

Aim: The occurrence of accelerated junctional rhythm during radiofrequency energy delivery at the region of the slow pathway is a well-recognized marker of successful treatment of atrioventricular nodal re-entry tachycardia (AVNRT). Our aim was to evaluate if the quantity and duration of accelerated junctional rhythm during radiofrequency ablation of the slow pathway is correlated with residual slow pathway conduction. Methods and results: Forty consecutive patients with AVNRT undergoing radiofrequency ablation of slow pathway who developed accelerated junctional rhythm during ablation were included. We compared accelerated junctional rhythm quantity and duration between two groups: group A, without echo beats and group B, with echo beats on post-ablation electrophysiology study. The total amount of accelerated junctional rhythm was significantly greater in group A than in group B [75.0 (63.5-165.0) vs. 36.0 (24.0-65.0), P=0.006], as well as total duration of accelerated junctional rhythm [47.0(33.5-81.0)ms vs. 23.0 (16.0-42.0)ms, P=0.006]. The cycle length of accelerated junctional rhythm did not differ between the two groups [510.0 (445.0-545.0)ms vs. 500.0 (450.0-585.0)ms, P=0.5). Conclusions: The amount and duration of accelerated junctional rhythm is correlated with the total abolishment abolition of slow pathway conduction. A higher amount and duration of accelerated junctional rhythm during radiofrequency applications may be an additional marker of successful ablation.