Slow junctional rhythm during catheter ablation of right posteroseptal accessory pathway causing transient atrioventricular block.
A male patient with palpitations and syncope during an episode of atrial fibrillation was evaluated. After DC cardioversion, the ECG showed a pattern of pre-excitation compatible with right posteroseptal bypass tract. The patient was submitted to RF. During energy application a slow junctional rhythm without AV block was noted. Twenty-four hours after the procedure AV block was observed. The AV conduction was resumed spontaneously 48 hours later with unremarkable outcome up to 1 year. We postulated that the edema caused by RF application damaged the compact AV node, causing transient AV block. The AV node lesion has been manifested by a fast junctional rhythm, but in this case we observed that even a slow junctional rhythm could do it.
Moreira
José Marcos
JM
Cardiology Service, Hospital do Servidor Público Estadual, São Paulo, Brazil. josemmoreira@.ig.com.br
Curimbaba
Jefferson
J
Pimenta
João
J
D017115:Catheter Ablation / Q000009:adverse effects; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006327:Heart Block / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology / Q000601:surgery*