Complete atrioventricular block following internal electrical cardioversion during atrial fibrillation ablation,Journal of Electrocardiology

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Complete atrioventricular block following internal electrical cardioversion during atrial fibrillation ablation
Journal of Electrocardiology ( IF 1.3 ) Pub Date : 2023-12-15 , DOI: 10.1016/j.jelectrocard.2023.12.005
Takashi Nakashima , Mikihito Morimoto , Masaru Nagase , Taro Shibahara , Daiju Ono , Takehiro Yamada , Gen Tanabe , Keita Suzuki , Makoto Yamaura , Takahisa Ido , Shigekiyo Takahashi , Hiroyuki Okura , Takuma Aoyama

Background

Complete atrioventricular block (C-AVB) following internal electrical cardioversion (IEC) during atrial fibrillation (AF) ablation has not been fully investigated. We aimed to determine the prevalence and predictors of C-AVB following IEC during AF ablation.

Methods

C-AVB (non-conducted sinus impulse after IEC) and ventricular pause (VP) (the interval between IEC and the QRS complex) following the first attempt of IEC, and baseline electrocardiographic parameters were investigated in patients who underwent first-time AF ablation.

Results

We investigated the first attempt of IEC in 124 patients (mean age:70 ± 11 years, 81 men, 99 non-paroxysmal AF). AF was terminated in 109/124 (88%) patients, with a VP of 1590 [1014–2208] (maximum, 8780) ms. Transient C-AVB following IEC occurred in 14/109 (13%) patients. The VP was longer in patients with transient C-AVB than in those without transient C-AVB (2418 [1693–4425] vs. 1530 [876–2083] ms, p = 0.002). In multivariate analysis, the left atrial diameter (Odds ratio [OR]:1.21; 95% confidence interval (95%CI):1.06–1.39; p = 0.005) and preexisting intraventricular conduction abnormality (OR:9.22; 95%CI:1.60–53.3; p = 0.013) were predictors of transient C-AVB following IEC.

Conclusion

Left atrial diameter and preexisting intraventricular conduction abnormalities were predictors of transient C-AVB following IEC during AF ablation.

中文翻译：

房颤消融期间内电复律后完全性房室传导阻滞

背景

房颤 (AF) 消融期间内电复律 (IEC) 后的完全性房室传导阻滞 (C-AVB)尚未得到充分研究。我们的目的是确定 AF 消融期间 IEC 后 C-AVB 的患病率和预测因素。

方法

首次尝试 IEC 后的 C-AVB（IEC 后非传导窦性冲动）和心室停顿 (VP)（IEC 与 QRS 波群之间的间隔），以及首次接受 AF 消融的患者的基线心电图参数。

结果

我们对 124 名患者进行了首次 IEC 尝试（平均年龄：70 ± 11 岁，81 名男性，99 名非阵发性 AF）。109/124 (88%) 名患者终止了 AF，VP 为 1590 [1014–2208]（最大 8780）ms。IEC 后短暂的 C-AVB 发生在 14/109 (13%) 患者中。短暂性 C-AVB 患者的 VP 比无短暂性 C-AVB 的患者更长（2418 [1693–4425] vs. 1530 [876–2083] ms，p = 0.002）。在多变量分析中，左心房直径（比值比 [OR]：1.21；95% 置信区间 (95%CI)：1.06–1.39；p = 0.005）和先前存在的心室内传导异常（OR：9.22；95%CI：1.60） –53.3；p = 0.013）是 IEC 后瞬态 C-AVB 的预测因子。