Junctional Rhythm and Slow Pathway Blok as Successful Ablation Indicatives Applied to AVNRT of Slow Pathway Ablation

Objective:To evaluate junction rhythm and atria pacemaking to show pathway conduction block as successful ablation indicatives applied in AVNRT of slow pathway ablation and compare the difference of discharge time and ablation targets to ablation endpoint.Methods:153 patients with AVNRT were performed slow pathway radiofrequency ablation. According to characteristics of X-ray image and local electrograms the dischargeing power of ablation target was ascertained for 10～40W.Regarding to different successful ablation monitoring indicatives,patients were divided into ablation group in traditional method(GroupⅠ)and ablation group with atria pacemaking showing slow pathway conduction block as successful ablation indicative(GroupⅡ).86of GroupⅠ presented junction rhythm in dischargeing 15s or early pacemade then consecutively discharged 60～90 seconds;In GroupⅡ 67 patients after dischargeing 15s showed junction rhythm or after early pacemaking delayed dischargeing to 20s then stopped dischargeing.Before procedure AV1︰1 the shortest interval atrium stimulation(S1S1)showed slow pathway block and stopped pacemaking then continuously delivered up to 60s.If not deliver to ablation end-point,continuing to select sites ablating till delivered to ablation end-point.Results: All patients in two groups delivered to ablation end-point.Ablation end-points and end-points types between two groups were no difference.In 86 of groupⅠ 306 targets were successfully ablated,3.59±1.21 targets per were ablated and dischargeing time was 208.94±89.26s;In 67 of groupⅡ all successful ablation targets were 150,2.24±0.94 targets per patient were ablated and dischargeing time was 114.83±38.97s.All parameter including all items per patients in groupⅠ were higher than in groupⅡ.The comparison between two groups lied in significant difference(P0.05).Within 15s no effective ablation did not involve in targets.Conclusions: To show slow pathway conduction block as successful ablation indicative can monitor objectively the efficiency of discharged ablation and attenuate myocardial injury of ineffective ablation.