Bradycardia-induced polymorphic ventricular tachycardia after radiofrequency catheter modification of atrioventricular junction.

Abstract

We report the case of a 59-year-old man with a dilated nonischemic cardiomyopathy who had chronic rapid atrial fibrillation despite several therapies. Radiofrequency modification of the atrioventricular (AV) junction slowed the mean ventricular rate from 120 beats per minute (bpm) to 60 bpm. Five hours after the procedure and during the following 1 week, despite ventricular pacing at 90 bpm, the patient developed nonsustained or sustained polymorphic ventricular tachycardias. Finally, pacing at 90 bpm was successfully used in this patient. In conclusion, patients who have undergone modification of AV conduction may be at high risk of life-threatening ventricular arrhythmias in the first week following the procedure.

AI evidence extraction

Main findings

After radiofrequency modification of the AV junction reduced mean ventricular rate from 120 bpm to 60 bpm, the patient developed nonsustained or sustained polymorphic ventricular tachycardias starting 5 hours post-procedure and during the following week, despite ventricular pacing at 90 bpm. The authors conclude there may be a high risk of life-threatening ventricular arrhythmias in the first week after AV conduction modification.

Outcomes measured

• Bradycardia-induced polymorphic ventricular tachycardia
• Nonsustained polymorphic ventricular tachycardia
• Sustained polymorphic ventricular tachycardia
• Ventricular rate change after AV junction modification
• Need for ventricular pacing

Limitations

• Single-patient case report
• No quantitative exposure parameters (e.g., RF frequency, power, lesion details) reported in abstract
• No control/comparator group

{
    "study_type": "case_report",
    "exposure": {
        "band": null,
        "source": "radiofrequency catheter modification of atrioventricular junction",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "59-year-old man with dilated nonischemic cardiomyopathy and chronic rapid atrial fibrillation",
    "sample_size": 1,
    "outcomes": [
        "Bradycardia-induced polymorphic ventricular tachycardia",
        "Nonsustained polymorphic ventricular tachycardia",
        "Sustained polymorphic ventricular tachycardia",
        "Ventricular rate change after AV junction modification",
        "Need for ventricular pacing"
    ],
    "main_findings": "After radiofrequency modification of the AV junction reduced mean ventricular rate from 120 bpm to 60 bpm, the patient developed nonsustained or sustained polymorphic ventricular tachycardias starting 5 hours post-procedure and during the following week, despite ventricular pacing at 90 bpm. The authors conclude there may be a high risk of life-threatening ventricular arrhythmias in the first week after AV conduction modification.",
    "effect_direction": "harm",
    "limitations": [
        "Single-patient case report",
        "No quantitative exposure parameters (e.g., RF frequency, power, lesion details) reported in abstract",
        "No control/comparator group"
    ],
    "evidence_strength": "very_low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency catheter modification",
        "atrioventricular junction",
        "atrial fibrillation",
        "bradycardia",
        "polymorphic ventricular tachycardia",
        "ventricular pacing",
        "cardiomyopathy"
    ],
    "suggested_hubs": []
}

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