Curative Therapy for Supraventricular Arrhythmia with Radiofrequency Catheter Ablation—Comparison with Surgical Therapy

1993 ◽  
Vol 1 (4) ◽  
pp. 166-173
Author(s):  
Wee Siong Teo ◽  
Ruth Kam ◽  
Arthur Tan ◽  
James Wong ◽  
Ong Kim Kiat
Keyword(s):  
Drug Therapy ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Heart Surgery ◽  
Accessory Pathway ◽  
Open Heart Surgery ◽  
Supraventricular Arrhythmia ◽  
Curative Therapy ◽  
Accessory Pathways

Radiofrequency catheter ablation is a newly introduced technique that does not require open heart surgery and is designed for curing patients with arrhythmia. We present our experience with this technique in 223 patients, with recurrent supraventricular tachycardia due to accessory pathways associated with the Wolff-Parkinson-White syndrome or AV nodal reentrant tachycardia. Of the patients, 119 underwent radiofrequency ablation of accessory pathways, while 101 underwent AV nodal modification. Two patients underwent both AV nodal modification and accessory pathway ablation during the same session. One patient had AV nodal ablation. Mean age was 39.4 ± 14.1 years (13–73 years). There were 108 males and 115 females. Except for 1 patient, all had significant symptoms. Radiofrequency ablation performed during the first session was successful in 215 patients (96.4%). With repeat ablation, 218 (97.8%) of the patients were successfully ablated. When compared with surgery, the efficacy is similar; however, radiofrequency ablation is less costly and results in less morbidity. Radiofrequency catheter ablation is highly efficacious and is the treatment of choice in patients who are at risk for sudden death or have failed drug therapy. It should also be offered as an alternative to lifelong drug therapy.

Risk factors of recurrence and complication in radiofrequency catheter ablation of atrioventricular reentrant tachycardia in children and adolescents

2013 ◽  
Vol 23 (5) ◽  
pp. 682-691 ◽  
Author(s):  
Tien H. Chen ◽  
Ming-Lung Tsai ◽  
Po-Cheng Chang ◽  
Hung-Ta Wo ◽  
Chung-Chuan Chou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Catheter Ablation ◽  
Children And Adolescents ◽  
Radiofrequency Catheter Ablation ◽  
Congenital Heart ◽  
Accessory Pathway ◽  
Reentrant Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Accessory Pathways

AbstractBackgroundTo compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic atrioventricular reentrant tachycardia in children and adolescents.MethodsWe retrospectively reviewed the data of 213 consecutive patients with symptomatic atrioventricular reentrant tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age <12 years) and adolescents (12 ≤ age < 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups.ResultsThe position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children.ConclusionsThe findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of atrioventricular reentrant tachycardia in children and adolescents.

Slow and wide QRS complex tachycardia as a unique complication following radiofrequency catheter ablation of a left-sided accessory pathway in a child

2005 ◽  
Vol 15 (3) ◽  
pp. 315-318 ◽  
Author(s):  
Radu Vatasescu ◽  
Laszlo Kornyei ◽  
Tamas Szili-Torok
Keyword(s):  
Catheter Ablation ◽  
Slow Rate ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Qrs Complex ◽  
White Syndrome ◽  
Accessory Pathways ◽  
Radiofrequency Lesions ◽  
Transaortic Approach ◽  
Wolff Parkinson White Syndrome

Radiofrequency lesions can, theoretically, be the substrate for new persistent arrhythmias. As far as we know, this has never previously been encountered after transcatheter ablation of accessory pathways. A child with Wolff–Parkinson–White syndrome was referred for radiofrequency catheter ablation of a left-sided accessory pathway. After successful ablation of the accessory pathway using a retrograde transaortic approach, the child developed an incessant wide QRS complex tachycardia at slow rate that was resistant to pharmacologic interventions. The focus of the tachycardia was identical to the ventricular site of insertion of the eliminated accessory pathway.

scholarly journals Radiofrequency Catheter Ablation of Parahisian Accessory Pathway

2016 ◽  
Vol 1 (1) ◽  
pp. 92-96
Author(s):  
Szilamér Korodi ◽  
István Kovács ◽  
Edvin Benedek ◽  
András Mester ◽  
Laura Jani ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
High Risk ◽  
Catheter Ablation ◽  
Low Power ◽  
Atrioventricular Block ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Complete Atrioventricular Block ◽  
Radiofrequency Current ◽  
Complete Atrioventricular

Abstract Radiofrequency catheter ablation of parahisian accessory pathways in pre-excitation syndrome is a challenging task, due to the extremely high risk of complete atrioventricular block. In this brief report we describe the case of a 32 year-old man presenting a parahisian accessory pathway, who has been successfully treated by radiofrequency ablation. Radiofrequency catheter ablation using low-power radiofrequency current is considered to be the most appropiate method of ablation in adult 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

scholarly journals EFFICIENCY AND SAFETY OF RADIOFREQUENCY CATHETER ABLATION OF ATRIAL FIBRILLATION IN ELDERLY PATIENTS

2017 ◽  
Vol 8 (2) ◽  
pp. 34-41
Author(s):  
M H Fedorova ◽  
A V Chapurnykh ◽  
V B Nizhnichenko ◽  
S V Lakomkin ◽  
V L Doshicin
Keyword(s):  
Atrial Fibrillation ◽  
Drug Therapy ◽  
Radiofrequency Ablation ◽  
Catheter Ablation ◽  
Elderly Patients ◽  
Radiofrequency Catheter Ablation ◽  
Risk Of Death ◽  
Group A ◽  
People Group ◽  
Methods Of Treatment

Atrial fibrillation is one of the most frequent and significant rhythm disturbances. The effectiveness and expediency of using one of the most effective methods of treatment of this arrhythmia (radiofrequency ablation in elderly patients) remains a controversial and insufficiently studied issue. The article compares the results of the treatment of 63 patients of mature age (up to 75 years) and senile age (from 75 years). Patients underwent 78 operations of radiofrequency catheter ablation of atrial fibrillation and atypical atrial flutter, which was resistant to drug therapy. In the groups of patients of mature and senile age, there were no statistically significant differences in the effectiveness of treatment. In elderly people group, a higher incidence of complications was found mainly due to hydrothorax, but these complications did not increase the risk of death and were stopped during treatment. This allows to conclude that the senile age of patients should not be the reason for refusing to conduct radiofrequency catheter ablation.

scholarly journals Radiofrequency catheter ablation of right atriofascicular (Mahaim) accessory pathways guided by accessory pathway activation potentials.

Circulation ◽  
1994 ◽  
Vol 89 (6) ◽  
pp. 2655-2666 ◽  
Author(s):  
J H McClelland ◽  
X Wang ◽  
K J Beckman ◽  
H A Hazlitt ◽  
M I Prior ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Accessory Pathways ◽  
Pathway Activation

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

2014 ◽  
Vol 9 (1) ◽  
pp. 18-24
Author(s):  
S Hashem ◽  
M Hossain ◽  
MA Ali ◽  
AK Chowdhury ◽  
Habib SM Ahsan ◽  
...  
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.v9i1.19507 University Heart Journal Vol. 9, No. 1, January 2013; 18-24

scholarly journals Successful ablation of a left anterior accessory pathway from the left coronary sinus of Valsalva near the aortic–mitral continuity

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199024
Author(s):  
Fan Wang ◽  
Xuelian Song ◽  
Yi Dang ◽  
Shangzhi Shu ◽  
Shuyan Li
Keyword(s):  
Catheter Ablation ◽  
Coronary Sinus ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Sinus Of Valsalva ◽  
Long Term Outcomes ◽  
Accessory Pathways ◽  
Successful Ablation

Catheter ablation of accessory pathways can be challenging depending on the location of these pathways, and accessory pathways are rare through the aortic cusps. We report a patient who underwent radiofrequency catheter ablation for manifestation of a left anterior accessory pathway from the left coronary sinus of Valsalva near the aortic–mitral continuity. Anterior accessory pathways can be safely and effectively ablated from the aortic cusps with favorable long-term outcomes.

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