Junctional ectopic rhythm after AVNRT ablation: An underrecognized complication

Nathan Kusterer, Gustavo Morales, Muhammad Butt, Yousef Darrat, Kevin Parrott, Gbolahan Ogunbayo, Katrina Bidwell, Ripa Patel, Brian Delisle, Melissa Czarapata, Claude S. Elayi

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Ablation is an effective treatment for atrioventricular nodal reentrant tachycardia (AVNRT). The occurrence of junctional ectopic rhythm (JER), including junctional ectopic tachycardia, following AVNRT ablation has been described as an extremely rare phenomenon, but may be underestimated. We aimed to determine the incidence of JER following AVNRT ablation within our institution, as well as that reported in the literature via an extensive review. Methods: We reviewed our adult ablation institutional experience for the occurrence of JER after AVNRT ablation from 2009 to 2016. Additionally, we conducted an extensive literature search using different databases looking for AVNRT ablation case series. The individually reported complications of these studies were reviewed, with a primary endpoint defined as the occurrence of JER shortly after AVNRT ablation. The study was approved by our institutional review board. Results: Our institutional data revealed 6/126 patients (prevalence 4.8%) developed non-preexisting JER post-AVNRT ablation. Four patients were asymptomatic. Two patients had persistent symptoms lasting over a year, with one patient requiring repeat ablation. The literature review included 149 adult and pediatric studies. There were three cases of reported JER, out of a total of 37,541 patients (31,768 adults and 5,773 pediatric; prevalence 0.008%). The three JER patients were pediatric, and all required further therapeutic intervention. Conclusion: JER might be an underreported complication of AVNRT ablation. It seems most often to be transient and self-limited, occurring days to weeks after ablation, but may also be debilitating, requiring more aggressive management.

Original languageEnglish
Pages (from-to)182-193
Number of pages12
JournalPACE - Pacing and Clinical Electrophysiology
Volume41
Issue number2
DOIs
StatePublished - Feb 2018

Bibliographical note

Publisher Copyright:
© 2017 Wiley Periodicals, Inc.

Keywords

  • AVNRT
  • ablation
  • junctional ectopic rhythm
  • junctional ectopic tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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