title: Atrial asystole during ventricular pacing following radiofrequency catheter ablation of accessory pathways.
abstract: Sinus node bradycardia or sinus node arrest is a documented phenomenon during radiofrequency catheter ablation. In addition, sinus node inhibition during ventricular pacing has been described as an infrequent occurrence in the course of diagnostic electrophysiology studies. The proposed mechanism in both situations is intense stimulation of vagal afferent pathways leading to a Bezold-Jarisch-like phenomenon. In the present report, we describe a series of three cases of atrial asystole during ventricular pacing following radiofrequency catheter ablation of accessory pathways. Potential pathophysiologic mechanisms are discussed.
authors.affiliation: Electrophysiology and Arrhythmia Unit IDIBELL, Cardilogy Department, Hospital Universitari de Bellvitge, L'Hospitalet, Barcelona, Spain. ignasi.anguera@gmail.com
authors.forename: Ignasi
authors.initials: I
authors.lastname: Anguera
authors.forename: Xavier
authors.initials: X
authors.lastname: Sabaté
authors.forename: Joan
authors.initials: J
authors.lastname: Nicolás
authors.forename: Enric
authors.initials: E
authors.lastname: Esplugas
mesh_terms: D058606:Accessory Atrioventricular Bundle / Q000601:surgery*; D000328:Adult; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004562:Electrocardiography; D006323:Heart Arrest / Q000209:etiology / Q000503:physiopathology; D006329:Heart Conduction System / Q000002:abnormalities* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult