Accelerated idioventricular rhythm complicating atrioventricular junction ablation for automatic atrial tachycardia

Mary Ann Goldstein, Ann Dunnigan, Nancy A. Staley, David G. Benditt, D. Woodrow Benson, Simon Milstein

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2 Scopus citations


A 13-year-old male with histologic evidence of cardiomyopathy, drug-refractory primary atrial tachycardias, and deteriorating left ventricular function underwent transcatheter His bundle ablation to control ventricular rate. Following an initial successful ablation at the level of the atrioventricular node, the patient exhibited an accelerated escape rhythm of apparent junctional origin (ventricular cycle length = 470 msec, HV = 100 msec) with complete heart block. A second ablation procedure was undertaken, following which an accelerated idioventricular rhythm (cycle length = 500 msec) became apparent and has persisted (follow-up 15 months). Thus, findings in this patient suggest that attempts to control refractory rapid ventricular responses in cardiomyopathy patients with primary atrial tachycardias may be complicated by the potential for junctional and idioventricular sites to exhibit similar abnormally accelerated subsidiary pacemaker function.

Original languageEnglish (US)
Pages (from-to)81-86
Number of pages6
JournalInternational Journal of Cardiology
Issue number1
StatePublished - Oct 1989

Bibliographical note

Funding Information:
This study was supported in part by the Dwan Family Fund and was completed during Dr. Goldstein’s tenure as a Kenneth M. Rosen Fellow of the North American Society for Pacing and Electrophysiology.


  • Atrioventricular junctional ablation
  • Cardiac electrophysiology
  • Primary atrial tachycardia


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