{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:59:32Z","timestamp":1785394772992,"version":"3.55.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12]]},"abstract":"\n Background<\/jats:title>\n Severe conduction delay and inter\/intra\u2010atrial dissociation may occur in patients who undergo an extensive catheter ablation or a maze procedure for atrial tachyarrhythmia. We report a series of patients with inter\/intra\u2010atrial dissociation that mimicked complete atrioventricular block or ventricular tachycardia.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n We retrospectively reviewed the medical records of 7 patients who were referred for the evaluation of atrioventricular block (patients 1\u20136) or ventricular tachycardia (patient 7) that occurred after biatrial maze procedure and valvular surgery. During the electrophysiologic study, slow atrial or junctional escape rhythm dissociated from isolated atrial activity mimicked complete atrioventricular blocks. Intra\u2010atrial dissociation of the right atrium or left atrium was observed. Atrioventricular nodal conduction from the nondissociated atrium to the ventricle was preserved in all patients, while the conduction from the dissociated atrium was blocked. In patient 7, the pacing of the ventricle by tracking of atrial tachycardia from the nondissociated left atrium\/coronary sinus mimicked ventricular tachycardia during pacemaker interrogation. A total of 5 patients received new permanent pacemaker implantations during the index hospitalization for the surgery (n=2) or as a deferred procedure (n=3) according to the treatment for sick sinus syndrome.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Pseudo\u2010atrioventricular block or pseudo\u2010ventricular tachycardia may occur because of inter\/intra\u2010atrial dissociation after a maze procedure. The selection of patients for permanent pacemaker implantation should be determined based on the patient\u2019s symptoms and the status of the escape pacemaker and not on the apparent atrioventricular block. Proper diagnosis is important to avoid unnecessary implantation of a pacemaker or a defibrillator.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.120.018241","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T10:19:59Z","timestamp":1605867599000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Inter\/Intra\u2010Atrial Dissociation in Patients With Maze Procedure and Its Clinical Implications: Pseudo\u2010Block and Pseudo\u2010Ventricular Tachycardia"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0222-0384","authenticated-orcid":false,"given":"Ungjeong","family":"Do","sequence":"first","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4391-5406","authenticated-orcid":false,"given":"Gi\u2010Byoung","family":"Nam","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsoo","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Soo","family":"Cho","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kee\u2010Joon","family":"Choi","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You\u2010Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.05.012"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.10.076"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(99)00231-3"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2010.25.5.712"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2011.00433.x"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2017.12.001"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2012.02347.x"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.14037"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.03.013"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.5402\/2011\/475796"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.05.066"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartasia-2018-011008"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt573"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.03.064"},{"issue":"139","key":"e_1_3_1_16_2","first-page":"e1","article-title":"A single center's experience with pacemaker implantation after the Cox maze procedure for atrial fibrillation","volume":"154","author":"Ad N","year":"2017","unstructured":"Ad N, Holmes SD, Ali R, Pritchard G, Lamont D. A single center's experience with pacemaker implantation after the Cox maze procedure for atrial fibrillation. J Thorac Cardiovasc Surg. 2017;154(139\u2013146):e1.","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.018241","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:04:51Z","timestamp":1715598291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.018241"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12]]},"references-count":15,"journal-issue":{"issue":"23","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1161\/JAHA.120.018241"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.018241","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12]]},"assertion":[{"value":"2020-07-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e018241"}}