During RF ablation of AVNRT, presence of junctional beats is an indication of slow pathway ablation.

• A. True
• B. False
• C. No relation
• D. Requires mapping

Answer: (A)

During RF ablation for AVNRT, the slow pathway lies in the posterior inferior region of the AV node. When energy is delivered in that area, irritation of the nodal tissue often produces AV junctional beats. This junctional rhythm serves as a practical signal that you are at or near the slow-pathway tissue being targeted and that the ablation is engaging the slow pathway to modify the reentrant circuit. It’s a helpful intra-procedural marker indicating you’re affecting the intended tissue without yet risking complete AV block. While not the sole determinant of success, the appearance of junctional beats during the ablation is considered a favorable sign of slow-pathway modification.