Sinus arrest during radiofrequency ablation of the atrioventricular-node slow pathway: Implications and possible mechanisms

Nilesh Mathuria, Jaromir Bobek, Hamid Afshar

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Radiofrequency ablation has been associated with changes in autonomic function. In this case, a 52-year-old woman was referred for electrophysiologic study of recurrent supraventricular tachycardia. Typical slow/fast atrioventricular node re-entry tachycardia was induced and confirmed during the study. Radiofrequency ablation of the slow pathway of the atrioventricular node led to sinus arrest, which resolved once ablation was stopped. Given the distance of the ablation site from the sinus node, we inferred that mechanisms other than direct injury to the sinus node were involved. To our knowledge, this is only the 2nd reported finding of sinus arrest during slow-pathway ablation of the atrioventricular node. This case highlights the complex interaction between the autonomic nervous system and the cardiac conduction system. Possible mechanisms include a Bezold-Jarisch reflex and modification of the intrinsic autonomic nervous system.

Original languageEnglish (US)
Pages (from-to)477-479
Number of pages3
JournalTexas Heart Institute Journal
Volume36
Issue number5
StatePublished - 2009

Keywords

  • Afferent pathways
  • Autonomic nervous system diseases
  • Catheter ablation/adverse effects
  • Electrophysiology
  • Heart conduction system
  • Parasympathetic nervous system
  • Radiofrequency ablation
  • Tachycardia, supraventricular/therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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