Atrial fibrillation is one of the most common cardiac arrhythmias encountered in clinical work. In recent years, some promising advances have been made in research concerning AF. In particular, radiofrequency ablation can be said to be a revolution in atrial fibrillation. However, in our primary hospitals, most patients with AF still need or heart rate control treatment. According to the classification method customarily used in the past. AF is divided into paroxysmal AF, slow AF, isolated AF, etc. Among them, the issue of slow AF with long R-R interval is more controversial.
Atrial fibrillation causing long R-R intervals is a very common electrocardiographic phenomenon in clinical practice. In the past, it was thought to be a manifestation of atrial fibrillation combined with second-degree, high-degree or even third-degree atrioventricular block. Later, it was found that many patients with AV block did not have second degree or high degree AV block after resetting to sinus. Therefore, the previous diagnosis was questioned. Atrial fibrillation with long R-R intervals is quite common in clinical practice. Traditionally, the diagnosis of AV block has focused more on the “degree” and the AV conduction ratio. Therefore, the presence of a long R-R interval in atrial fibrillation cannot be easily diagnosed as combined AV block. In contrast, the presence of a persistent slow atrioventricular junction or ventricular fugitive rhythm can suggest the combination of AF with partial or complete AV block. The criteria for definitive diagnosis of atrial fibrillation combined with second-degree AV block need to be further investigated. If AV block occurs in the prone position or at night, but disappears in the standing position, such “AV block” is obviously not clinically meaningful. Therefore, it is recommended that the diagnosis of “atrial fibrillation with second-degree AV block” be abandoned as soon as possible, and the diagnosis of “atrial fibrillation with long R-R interval” is more reasonable. After radiofrequency ablation of atrial fibrillation, the long interval will be restored and pacemaker implantation is not necessary. If a long interval is still present after RF ablation of atrial fibrillation. If syncope occurs, pacemaker implantation should be performed as soon as possible.