Intravenous atropine (1 mg) caused an 8.6 +/- 9.3% decrease in JER cycle length in the short-term setting compared with a 7.6 +/- 7.3% decrease in the long-term setting. However, there was no significant difference between short- and long-term responses, except at the highest dose of isoproterenol. Drug responses within each study were all significant when compared with baseline. Junctional recovery times increased exponentially as overdrive pacing rates increased-there was no difference between short-term and long-term responses. JER cycle length was 1526 +/- 298 milliseconds in the short-term setting and was present in 44 patients (98%) in the long-term setting, measuring 1426 +/- 223 milliseconds (P <. HV intervals before and after ablation were 49 +/- 9 and 48 +/- 9 milliseconds, respectively (P = NS). Short- and long-term responses were compared. Baseline characteristics and responses to overdrive ventricular pacing and intravenous atropine followed by an incremental isoproterenol infusion were determined. Short-term and noninvasive long-term follow-up studies were performed to examine the electrophysiological characteristics of the underlying JER in 45 patients who had undergone AV nodal ablation with RFC. However, the origin of the JER and short-term thermal effects of RFC on this junctional pacemaker activity are ill defined. Catheter ablation of the atrioventricular (AV) node with radiofrequency current (RFC) is associated with the short-term onset of a junctional escape rhythm (JER) in nearly all patients.
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