scholarly journals Electrophysiological study and radiofrequency catheter ablation in children with supraventricular tachycardias

QJM ◽  
2018 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
A Fathy Tamara ◽  
A Ali Ramzy
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Electrophysiological Study ◽  
Supraventricular Tachycardias

Concealed accessory pathways and related tachycardias

ESC CardioMed ◽  
2018 ◽  
pp. 2091-2092
Author(s):  
Carlo Pappone ◽  
Vincenzo Santinelli
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Node ◽  
Tricuspid Annulus ◽  
Atrioventricular Reentrant Tachycardia ◽  
Accessory Pathways ◽  
Purkinje System ◽  
Electrical Impulses ◽  
Supraventricular Tachycardias ◽  
Retrograde Conduction

Conduction from the atria to the ventricles normally occurs via the atrioventricular node–His–Purkinje system. Accessory pathways (APs) directly connect the atrium and ventricle and bypass the atrioventricular node, bridging the mitral or, less commonly, the tricuspid annulus. Concealed APs conduct electrical impulses retrogradely from the ventricles to the atria, but not antegradely from the atria to the ventricles. Approximately 40% of all APs are concealed, and orthodromic atrioventricular reentrant tachycardia due to concealed APs is present in up to 15% of patients with supraventricular tachycardias referred for catheter ablation. Most concealed APs are left-sided, exhibiting non-decremental retrograde conduction. Tachyarrhythmias due to concealed APs are managed similarly to those supraventricular tachycardias associated with manifest APs, and symptomatic tachyarrhythmias are successfully treated by radiofrequency catheter ablation in the majority of patients.

scholarly journals Radiofrequency Catheter Ablation of Left-sided Accessory Atrioventricular Pathways at Atrial Insertion Sites.

2013 ◽  
Vol 8 (2) ◽  
pp. 103-109
Author(s):  
Sabina Hashem ◽  
Mohsin Hossain ◽  
M Atahar Ali ◽  
Amal Kumar Choudhury ◽  
SM Ahsan Habib ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Radiofrequency Energy ◽  
Ablation Catheter ◽  
Accessory Pathways ◽  
Left Posterior ◽  
Primary Success ◽  
Insertion Sites

Background: This study assessed the efficacy and safety of techniques used to ablate left-sided accessory atrioventricular pathways at atrial insertion sites by retrograde aortic approach. Radiofrequency catheter ablation of left-sided accessory pathways by way of retrograde aortic approach can be highly successful. Methods: This study were done in the department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka from June 2009 and March 2010, a total 30 patients with recurrent SVT who has left sided accessory atrioventricular pathways found after electrophysiological study, underwent attempted radiofrequency catheter ablation of one or more accessory atrioventricular pathways by retrograde aortic approach. The ablation catheter was inserted into the femoral artery and passed retrogradely across the aortic valve .Once an optimal target site has been identified, radiofrequency energy at a pre-selected temperature of 55 - 60 0 C and power output set at 50 watts was delivered through the ablation catheter. Loss of preexcitation or interruption of the tachycardia within 5 seconds of RF application was considered effective and RF current was continued in this location 30 to 60 seconds. Ablation success was defined at completion of procedure as acutely successful or unsuccessful on the basis of successful elimination of all ablation targets. Results: During EP study it was found that 9 patients had concealed accessory pathways and 21 had manifest pre-excitation. WPW left-lateral pathway was present in 10 (33.3%), concealed left lateral in 08 (26.7%) ,WPW left posterior in 11 (36.7%), concealed left posterior in 1 (3.3%). Out of 30 accessory pathways, 24 were successfully interrupted with radiofrequency catheter ablation with a primary success rate of 80 %. The ratio of atrial/ ventricular electrogram in successful sites was 0.83 ±0.27 (0.53-1.46). There were no major complications with retrograde aortic approach. Six failed patients were ablated via transseptal method. Conclusion: The retrograde atrial insertion approach to left-sided accessory pathway ablation is very safe and high effective, especially suitable for the failed patients by using retrograde ventricular insertion ablation procedure and by using single-catheter ablation of accessory pathway. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16081 University Heart Journal Vol. 8, No. 2, July 2012

Radiofrequency catheter ablation for supraventricular tachycardias: Part II

1994 ◽  
Vol 3 (1) ◽  
pp. 77-80
Author(s):  
LG Futterman ◽  
L Lemberg
Keyword(s):  
Catheter Ablation ◽  
Cardiac Arrhythmias ◽  
Radiofrequency Catheter Ablation ◽  
Standard Treatment ◽  
Atrioventricular Node ◽  
Complication Rates ◽  
Efficacy And Safety ◽  
Percutaneous Catheter ◽  
Radiofrequency Current ◽  
Supraventricular Tachycardias

Use of percutaneous catheter ablation with radiofrequency current for cardiac arrhythmias is expanding rapidly. Technical ease, high success and low complication rates have allowed RFCA to become standard treatment for accessory AV connections and is the therapeutic procedure of choice for patients with atrioventricular node reentry tachycardias. Techniques still being investigated and evaluated for the treatment of supraventricular tachycardias include laser catheter ablation, cryocatheter ablation and microwave catheter ablation. With further clinical experience, the efficacy and safety of these and other procedures can be determined.

Clinical recurrence of palpitations following slow pathway ablation in patients with suspected paroxysmal supraventricular tachycardias but non-documented, non-inducible tachycardias

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
J Ramos Jimenez ◽  
A Marco Del Castillo ◽  
VC Lozano Granero ◽  
C Lazaro Rivera ◽  
R Salgado ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Electrophysiological Study ◽  
Accessory Pathway ◽  
Clinical Suspicion ◽  
Therapeutic Modality ◽  
P Value ◽  
Slow Pathway ◽  
Clinical Recurrence ◽  
Slow Pathway Ablation ◽  
Supraventricular Tachycardias

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Catheter ablation is recommended as first-line treatment in patients with atrioventricular nodal reentry tachycardias (AVNRT). However, the best therapeutic modality in patients with dual AV nodal physiology but non-inducible tachycardias in electrophysiological study (EPS) remains controversial, especially when no tachycardias have been documented. Our objective was to evaluate the results of empirical slow pathway ablation in patients showing dual AV nodal physiology but non-inducible AVNRT. Methods Multicenter, retrospective, observational registry of consecutive patients undergoing EPS due to clinical suspicion of paroxysmal supraventricular tachycardias (PSVT), but with no prior ECG documentation. Clinical, EPS and ablation (when performed) data were collected and andalyzed.  Results 427 patients of 12 centers were included. Mean age was 46.3 ±16.1 and 297 (69.6%) were females. AVNRT was induced in 188 patients (typical in 181 cases, atypical in 7). Dual AV nodal physiology with or without single nodal echo beats, but with no sustained tachycardia and without evidence of accessory pathway was present in 68 patients. Ablation of the slow pathway was performed in 187/188 patients with AVNRT and in 30/68 patients with dual physiology. Among subjects with non-inducible tachycardia, ablation reduced significantly recurrences (39.5% in non-ablated vs. 16.7%; p = 0.04), with a level equivalent to those with ablated AVNRT(14.4% vs. 16.7%; p = 0.75). Procedure-related complications were similar in both groups: empirical ablation n = 1; 3.3% vs. induced tachycardia n = 6; 3.2% (p = 0.98). Conclusions In patients with high clinical suspicion of PSVT but non-documented and non-inducible arrhythmias, the presence of dual AV nodal physiology makes AVNRT a likely mechanism of the clinical tachycardia. Catheter ablation of slow pathway reduces the risk of recurrence to a level equivalent to those with inducible and ablated AVNRT. AVNRT (n = 188) Dual nodal physiology (n = 68) p value Age (years) 48.6 ± 16.3 41.9 ± 14.0 <0.01 Female 71.8% 67.7% 0.52 Years symptomatic 9.3 ± 11.3 3.6 ± 8.1 <0.01 Sudden onset 83.9% 88.0% 0.54 Abrupt end 73.4% 74.6% 0.96 Previous rate-slowing drugs 30.9% 25.0% 0.36 Previous antiarrhythmic drugs 5.9% 2.9% 0.35 Isoproterenol in EPS 70.0% 89.7% <0.01

Radiofrequency catheter ablation of supraventricular tachycardias in patients with hypertrophic cardiomyopathy

1996 ◽  
Vol 10 (5) ◽  
pp. 527-530 ◽  
Author(s):  
Osamu Kinoshita ◽  
Morie Sekiguchi ◽  
Mitsuaki Isobe ◽  
Hiroaki Takenaka ◽  
Yoshikazu Yazaki ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Supraventricular Tachycardias

scholarly journals Ventricular tachycardia in normal heart

2000 ◽  
Vol 1 ◽  
pp. 12-19
Author(s):  
B Raut ◽  
Sabita Malla
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Natural History ◽  
Radiofrequency Catheter Ablation ◽  
Antiarrhythmic Drugs ◽  
Electrophysiological Study ◽  
Normal Heart ◽  
Implantable Defibrillators ◽  
Monomorphic Ventricular Tachycardia ◽  
Cardiovascular Evaluation

Ventricular tachycardia is usually thought occurring only in abnormal heart. But it can also occur in apparently normal heart. Cardiovascular evaluation is normal except for the arrhythmia. Monomorphic ventricular tachycardia is not always induced at electrophysiological study. The natural history isincompletely known, but recurrences are not uncommon. Antiarrhythmic drugs, radiofrequency catheter ablation and implantable defibrillators are useful therapeutic choices.Prognosis is good even though occasional cases of sudden deaths have been reported.

Association of age with clinical features and ablation outcomes of paroxysmal supraventricular tachycardias

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319685
Author(s):  
Pablo Ávila ◽  
David Calvo ◽  
María Tamargo ◽  
Aitor Uribarri ◽  
Tomas Datino ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Clinical Features ◽  
Electrophysiological Study ◽  
Structural Heart Disease ◽  
Continuous Variable ◽  
Recurrence Rates ◽  
Age Related ◽  
Acute Success ◽  
Supraventricular Tachycardias ◽  
Relationship Of

ObjectiveThe role of age in clinical characteristics and catheter ablation outcomes of atrioventricular nodal re-entrant tachycardia (AVNRT) or orthodromic atrioventricular re-entrant tachycardia (AVRT) has been assessed in retrospective studies categorising age by arbitrary cut-offs, but contemporary analyses of age-related trends are lacking. We aimed to study the relationship of age with epidemiological, clinical features and catheter ablation outcomes of AVNRT and AVRT.MethodsWe recruited 600 patients (median age 56 years, 60% female) with a confirmed diagnosis of AVNRT (n=455) or AVRT (n=145) by means of an electrophysiological study. They were interrogated for arrhythmia-related symptoms with a structured questionnaire and followed up to 1 year. We analysed age as a continuous variable using regression models and adjusting for relevant covariables.ResultsBoth typical and atypical forms of AVNRT upraised with age while AVRT decreased (p<0.001 by regression). Female sex predominance in AVNRT was not observed in older patients. Overall, these tachycardias became more symptomatic with ageing despite a longer tachycardia cycle length (p<0.001) and regardless of the presence of structural heart disease, with a higher proportion of dizziness, syncope, chest pain or dyspnoea (p<0.005 for all) and a lower presence of palpitations or neck pounding (p<0.001 for both). Age was not associated with catheter ablation acute success, periprocedural complications or 1-year recurrence rates (p>0.05 for all).ConclusionsAge, evaluated as a continuous variable, had a significant association with the clinical profile of patients with AVNRT and AVRT. Nevertheless, catheter ablation outcomes and complications were not significantly related to patients’ age.

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