{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T17:27:11Z","timestamp":1751822831472},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1996,5]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            Mechanisms and changes of electrophysiological (EP) characteristics in successful radiofrequency (RF) modification of right midseptal and posteroseptal areas for controlling rapid ventricular response to atrial fibrillation (Af) are not clear.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            We studied 50 patients with medically refractory paroxysmal Af. Group 1 consisted of 40 patients without dual atrioventricular (AV) node physiology with modification sites located in the mid\/posteroseptal area. Of the 40 patients, 36 had successful modification (follow-up of 14\u00b18 months), and 3 had AV block. Late follow-up electrophysiological study (98\u00b110 days) showed pattern 1 (67%) with prolongation of AV node effective refractory period (ERP, \u226540 milliseconds) and Wenckebach block cycle length (WBCL, \u226540 milliseconds); pattern 2 (22%) with prolongation of AH interval (\u226520 milliseconds), ERP, and WBCL; and pattern 3 (11%) without any change in AV node conduction parameter. Change in ventricular rate negatively correlated with change of WBCL in patterns 1 (\n            <jats:italic>r<\/jats:italic>\n            =\u2212.691,\n            <jats:italic>P<\/jats:italic>\n            =.019) and 2 (\n            <jats:italic>r<\/jats:italic>\n            =\u2212.90,\n            <jats:italic>P<\/jats:italic>\n            =.01). Group 2 consisted of 10 patients with dual AV node pathway; elimination of slow pathway property was performed. Late follow-up electrophysiological study (92\u00b17 days) showed that change in ventricular rate negatively correlated with change in AV node ERP (\n            <jats:italic>r<\/jats:italic>\n            =\u2212.926,\n            <jats:italic>P<\/jats:italic>\n            =.0001) and WBCL (\n            <jats:italic>r<\/jats:italic>\n            =\u2212.969,\n            <jats:italic>P<\/jats:italic>\n            =.0001). Four patients without significant modification effect had success after RF energy was delivered to higher levels (follow-up, 15\u00b17 months).\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            RF modification of right mid\/posteroseptal area is feasible in 92% of patients with paroxysmal Af. Mechanisms of successful modification might be elimination of posterior input and\/or partial injury of the compact node. Furthermore, simple elimination of slow pathway might be inadequate for control of ventricular rate in patients with little difference in conduction properties between fast and slow pathways.\n          <\/jats:p>","DOI":"10.1161\/01.cir.93.9.1690","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"1690-1701","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Electrophysiological Mechanisms in Successful Radiofrequency Catheter Modification of Atrioventricular Junction for Patients With Medically Refractory Paroxysmal Atrial Fibrillation"],"prefix":"10.1161","volume":"93","author":[{"given":"Shih-Ann","family":"Chen","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Huang","family":"Lee","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chern-En","family":"Chiang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin-Tai","family":"Tai","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsu-Juey","family":"Wu","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Chuan","family":"Cheng","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zu-Chi","family":"Wen","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuen-Wang","family":"Chiou","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwo-Chang","family":"Ueng","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mau-Song","family":"Chang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Medicine, National Yang-Ming University; School of Medicine, Veterans General Hospital-Taipei; and Shin-Kong Memorial Hospital (S.-H.L.), Taiwan, ROC."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90003-6"},{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-117-2-141"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960141010"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198201283060402"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1982.03330070039027"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.70.6.6499141"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.80.6.2598419"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.84.5.1934368"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.83.5.2022016"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(91)90516-C"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90084-E"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(87)80388-1"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1993.tb01635.x"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199207303270504"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.85.6.1591833"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1993.tb01216.x"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(93)90050-J"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1993.tb01597.x"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.90.5.7955187"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199410063311404"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)90757-9"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.90.3.8087935"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.48.3.549"},{"key":"e_1_3_1_24_2","first-page":"2019","volume":"4","year":"1969","unstructured":"Jose AD, Taylor RR. Autonomic blockade by propranolol and atropine to study intrinsic myocardial functioning man. J Clin Invest. 1969;4:2019-2031.","journal-title":"J Clin Invest"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.49.2.7249285"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.89.3.8124796"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(94)90047-7"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.14.5.447"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.32.1.69"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.21.2.201"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.32.2.170"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.25.4.439"},{"key":"e_1_3_1_33_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/8.3.347"},{"key":"e_1_3_1_34_2","first-page":"H754","volume":"243","year":"1982","unstructured":"Mazgalev T, Dreifus LS, Bianchi J, Michelson EL. Atrioventricular nodal conduction during atrial fibrillation in rabbit heart. Am J Physiol. 1982;243:H754-H760.","journal-title":"Am J Physiol"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1990.tb01076.x"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1990.tb01077.x"},{"key":"e_1_3_1_37_2","first-page":"H1015","volume":"259","year":"1990","unstructured":"Chorro FJ, Kirchhof CJHJ, Brugada J, Allessie MA. Ventricular response during irregular atrial pacing and atrial fibrillation. Am J Physiol. 1990;259:H1015-H1021.","journal-title":"Am J Physiol"},{"key":"e_1_3_1_38_2","unstructured":"Lesh MD Gibb WJ Epstein L. Electrotonic interaction between dual AV nodal pathways: evidence from RF ablation and a computer model. Circulation. 1992;86(suppl I):I-30. Abstract."},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90552-Z"},{"key":"e_1_3_1_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.91.4.1086"},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(94)00315-H"},{"key":"e_1_3_1_42_2","first-page":"1059","volume":"54","year":"1983","unstructured":"Sung RJ, Waxman HL, Saksena S, Juma Z. Sequence of retrograde atrial activation in patients with dual atrioventricular nodal pathways. Circulation. 1983;54:1059-1067.","journal-title":"Circulation"},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80229-1"},{"key":"e_1_3_1_44_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.86.3.1516205"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1993.tb01239.x"},{"key":"e_1_3_1_46_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.87.5.8491010"},{"key":"e_1_3_1_47_2","doi-asserted-by":"crossref","unstructured":"Janse MJ Capelle FJLV Anderson RH Touboul P Billette J. Electrophysiology and structure of the AV node of the isolated rabbit heart. In: Wellens HJJ Lie KI Janes MJ eds. The Conduction System of The Heart. Leiden Netherlands: Stenfer Kroese; 1976:296-315.","DOI":"10.1007\/978-94-009-9726-4_17"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.1987.252.2.C163"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.93.9.1690","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T15:47:58Z","timestamp":1715528878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.93.9.1690"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,5]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[1996,5]]}},"alternative-id":["10.1161\/01.CIR.93.9.1690"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.93.9.1690","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,5]]},"assertion":[{"value":"1995-09-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1995-11-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1996-05-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}