Radio Frequency Ablation of right sided accessory pathway - 8 years experience at SGNHC

Background Radiofrequency ablation has been established as the curative treatment for most of supraventricular tachycardia since 1987. In SGNHC, ablation has been done routinely since 2003. In our experience, right sided accessory pathway (AP) has been technically difficult and challenging with low success rate as mentioned in literature outside. So, the objective of this article was to analyze the demographic characteristics, success and recurrence rate and complication of right sided AP ablation in our centre. Methods and Materials From 13th Oct 2003 to 9th Sept. 2011, altogether 768 patients who underwent ablation were analyzed. Result Among 768 patients, 416(54.2%) were accessory pathways out of which 72(17.3%) were right sided AP. Majority of right sided accessory pathway were manifest (WPW) comprising 77.1%, significantly higher compare to left sided pathway where manifest AP was only 44.1 % (p< 0.001). Among all attempted ablation of right sided AP, 11 ablations failed so that the success rate was 84.7% lower than that of left sided pathway where success rate was 98.4% (p<0.001). Among 61 successful ablations, 2 relapsed during follow up period, recurrence rate being 3.3%. Although there were few complications in the ablation of other tachyarrhythmia, there was no complication noted during the ablation of 72 right sided AP. Conclusion Right sided pathway are mostly manifest. The success rate of right sided pathway is lower in comparison to left sided pathway. Our success rate is comparable to the result in the literature which indicates that ablation of right sided accessory pathway in our centre is reasonably good. DOI: http://dx.doi.org/10.3126/njh.v8i1.8332 Nepalese Heart Journal Vol.8(1) 2011 pp.19-22

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Learning curve in performing radiofrequency ablation of accessory pathways in patients with Wolf-Parkinson-White syndrome

Medicinski pregled ◽

10.2298/mpns0610468v ◽

2006 ◽

Vol 59 (9-10) ◽

pp. 468-471

Author(s):

Dejan Vukajlovic ◽

Aleksandar Neskovic

Keyword(s):

Radiofrequency Ablation ◽

Learning Curve ◽

Success Rate ◽

Radiofrequency Energy ◽

Operator Experience ◽

Wpw Syndrome ◽

Accessory Pathways ◽

Group A ◽

Group B

Introduction. This study examines the effect of operator experience on radiofrequency ablation (RFA) of accessory pathways success rate in patients with Wolff-Parkinson-White (WPW) syndrome. Material and methods. The first 100 consecutive patients with WPW syndrome treated by radiofrequency ablation at our Clinic, were divided into group A (first 50 patients) and group B (the following 50 patients). Various parameters were compared between these 2 groups. Results. The success rate in group A was 69% and in group B 92%, p<0,01. There were 6 patients with recurrent WPW syndrome, after 3 months of follow-up, 5 were from group A and 1 from group B, p<0,05. Significantly more applications of radiofrequency energy were delivered in group A (10,0?4,8 in group A and 6,2 ?3,1 in group B, p<0,05). Two patients from group A presented with complications: one had intermittent complete AV-block, and the other pericardial effusion. Conclusion. This study shows a clear learning curve in performing RFA of accessory pathways in patients with WPW syndrome. .

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Radiofrequency Catheter Ablation of WPW Syndrome in National Institute of Cardiovascular Diseases, Dhaka: Initial and Four Years Follow-up Results

Cardiovascular Journal ◽

10.3329/cardio.v2i2.6638 ◽

1970 ◽

Vol 2 (2) ◽

pp. 188-194

Author(s):

MA Ali ◽

MM Hossain ◽

M Aziz ◽

M Rahman ◽

MS Hossain ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Catheter Ablation ◽

Success Rate ◽

Accessory Pathway ◽

Rf Ablation ◽

Wpw Syndrome ◽

Electrophysiological Studies ◽

Long Term Follow Up

Background: Radiofrequency (RF) catheter ablation is an effective method of treatment of patients with WPW syndrome. The purpose of this study was to analyze the initial and follow-up results of RF ablation of such cases in our hospital. Methods: 255 cases with WPW syndrome that had delta wave in sinus rhythm ECG underwent electrophysiological studies in this hospital. All the cases underwent radiofrequency ablation. These cases are selected for analysis. Results: Ablations were performed in these 255 patients between December 2005 and December 2008. One accessory pathway (AP) was found in 250 patients, two accessory pathways-in 05 patients. The mean duration of the procedure was 130 ± 32 min. The initial and overall success rate was 92.15% and 95.68% respectively. Major complications encountered are none. Conclusions: RF ablation of WPW syndrome has good initial (92.15%) and overall (95.68%) success rate and low recurrence rate (5.00%) at long term follow-up. Keywords: Catheter ablation; Radiofrequency ablation; WPW syndrome. DOI: 10.3329/cardio.v2i2.6638Cardiovasc. j. 2010; 2(2) : 188-194

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46: Intermediate Follow-Up Comparison between Partial Nephrectomy and Radio Frequency Ablation in T1A Renal Tumors

The Journal of Urology ◽

10.1016/s0022-5347(18)32313-9 ◽

2006 ◽

Vol 175 (4S) ◽

pp. 16-16 ◽

Cited By ~ 3

Author(s):

Joshua M. Stern ◽

Robert S. Svatek ◽

Sangtae Park ◽

J. Kyle Anderson ◽

Yair Lotan ◽

...

Keyword(s):

Radio Frequency ◽

Partial Nephrectomy ◽

Radio Frequency Ablation ◽

Renal Tumors

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Long-Term Follow-Up After Radiofrequency Ablation of Paroxysmal Supraventricular Tachycardia in Patients With Tachycardia-Induced Atrial Fibrillation

The American Journal of Cardiology ◽

10.1016/s0002-9149(97)00753-4 ◽

1997 ◽

Vol 80 (12) ◽

pp. 1609-1610 ◽

Cited By ~ 17

Author(s):

Raul Weiss ◽

Bradley P Knight ◽

Marwan Bahu ◽

Adam Zivin ◽

Joseph Souza ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Supraventricular Tachycardia ◽

Paroxysmal Supraventricular Tachycardia ◽

Long Term Follow Up

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Radio-frequency ablation (RFA) is equivalent in therapeutic effect but safer compared to microwave coagulation therapy (MCT) for hepatocellular carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.15064 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 15064-15064

Author(s):

T. Beppu ◽

T. Masuda ◽

T. Ishiko ◽

H. Hayashi ◽

S. Sugiyama ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radio Frequency ◽

Recurrence Rate ◽

Radio Frequency Ablation ◽

Tumor Seeding ◽

Microwave Coagulation Therapy ◽

Ablation Therapy ◽

Microwave Coagulation ◽

Coagulation Therapy

15064 Background: Radio-frequency ablation (RFA) and microwave coagulation therapy (MCT) have been developed as a useful locoregional treatment for hepatocellular carcinoma (HCC). It is still unclear which ablation therapy is superior for the patients with HCC, from the viewpoint of not only short term but also long term outcome. Methods: Between January 1991 and December 2005, 430 patients with HCC were treated with ablation therapy (230 RFA and 200 MCT) in our institution. Enroll criteria of this therapy were as follows; 1) unresectable HCCs, 2) each smaller than 3 cm, 3) up to three nodules, 4) without vascular invasion. Either percutaneous (P), endoscopic (E) or open (O) approach was selected individually based on location, size, number, or other factors. Treatment was repeated until complete ablation of HCC. Results: 1. Proportion of Child B or C was 62% and 60%; Stage III or IV was 56% and 58% in the patients with RFA and MCT, respectively. 2. Average tumor size and tumor number was 27mm/2.5 and 26mm/1.9 in the two groups. 3. Approaches were P: 55%, E: 33%, O: 12% in RFA and P: 48%, E: 30%, O: 22% in MCT. 4. Number of treatment was 1.1 in RFA and 1.2 in MCT. 5. Recurrence rate at the therapeutic site was 8% in RFA and 12% in MCT. Especially, endoscopic RFA provided a quite low recurrence rate (3%). 6. Cumulative 5-year survival was 52% versus 45% in the two groups. 7. Complication rate was significantly lower in RFA (5%) compared to MCT (11%). Intraabdominal tumor seeding (1% in MCT) and liver abscess formation (4% in MCT) was never encountered in RFA. Conclusions: Radio-frequency ablation for hepatocellular carcinoma is a safer procedure and can provide a similar favorable long- term prognosis compared to microwave coagulation therapy. No significant financial relationships to disclose.

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Electrophysiology and Radio frequency Ablation - A Novel Method of Treatment in Cardiology

Nepalese Heart Journal ◽

10.3126/njh.v4i1.26152 ◽

2006 ◽

Vol 4 (1) ◽

pp. 22-26

Author(s):

Sujeeb Rajbhandari

Keyword(s):

Radiofrequency Ablation ◽

Radio Frequency ◽

Cardiac Catheterization ◽

Cardiac Arrhythmias ◽

Cardiac Electrophysiology ◽

Radio Frequency Ablation ◽

Catheterization Laboratory ◽

Cardiac Catheterization Laboratory ◽

Interventional Technique ◽

Novel Method

Cardiac Electrophysiology and Radiofrequency Ablation (EPS & RFA) is one of the newer modalities of treatment in the field of cardiology. This method of treatmentis directed towards cardiac arrhythmias. Gone are the days when a doctor had to rely on medications to treat such conditions. It's an interventional technique which requires catheters, an EP lab system, cardiac catheterization laboratory and an Electrophysiologist.

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707 Transvenous radiofrequency ablation of epicardial posterior-septal accessory pathways in children with WPW syndrome: can technology and imaging innovations improve the outcome?

European Heart Journal Supplements ◽

10.1093/eurheartj/suab127.028 ◽

2021 ◽

Vol 23 (Supplement_G) ◽

Author(s):

Vincenzo Pazzano ◽

Pietro Paolo Tamborrino ◽

Corrado Di Mambro ◽

Massimo Stefano Silvetti ◽

Fabrizio Drago

Keyword(s):

Radiofrequency Ablation ◽

Success Rate ◽

Coronary Sinus ◽

Young Patients ◽

Ct Reconstruction ◽

Accessory Pathways ◽

Acute Success ◽

Angio Ct ◽

Septal Localization ◽

Lost To Follow Up

Abstract Aims The aim of the study was to analyse our recent single-centre experience about epicardial posterior-septal accessory pathways transcatheter ablation in children and young patients using radiofrequency through the coronary sinus, in order to understand which mapping and ablation strategy is associated with higher success rate and safety. Methods and results We reviewed all the cases of ablation of overt accessory pathways (in Wolff–Parkinson–White syndrome) with epicardial posterior-septal localization performed in children or young patients at our institution in the last 5 years. Twenty-two paediatric patients (mean age: 13 ± 3 years) with epicardial posterior-septal accessory pathways (15 in coronary sinus and 7 in the Middle Cardiac Vein) underwent radiofrequency transcatheter ablation with CARTO 3TM. Acute success rate was 77%. No patient was lost to follow-up (mean time 14.4 ± 9 months). The recurrence rate was 18%. Two patients underwent a successful redo-procedure; the overall long-term success rate was 68%. NAVISTAR® catheter presented the highest acute success rate in the coronary sinus. NAVISTAR SMARTTOUCH® was the only catheter that did not present recurrences after the acute success and it was successfully used in two patients previously unsuccessfully treated with a NAVISTAR THERMOCOOL®. Integration with angio-CT of coronary sinus branches obtained with CARTOMERGE was associated with higher success rate in patients with a previous failed ablation attempt. Conclusions Epicardial posterior-septal accessory pathways can be successfully treated with transvenous radiofrequency ablation in more than half of the cases in children/young patients. Acute success rate does not seem to depend on catheters used but contact-force catheter seems to be useful in cases with recurrences. Image integration with cardiac-CT reconstruction of coronary sinus branches anatomy can be useful to better guide ablation in case of previously failed attempts.

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The Association of Left Atrial Appendage Morphology to Atrial Fibrillation Recurrence After Radiofrequency Ablation

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.677885 ◽

2021 ◽

Vol 8 ◽

Author(s):

Shiyu Gong ◽

Jian Zhou ◽

Bingyu Li ◽

Sheng Kang ◽

Xiaoye Ma ◽

...

Keyword(s):

Atrial Fibrillation ◽

Radiofrequency Ablation ◽

Recurrence Rate ◽

Morphological Feature ◽

Left Atrial ◽

Left Atrial Appendage ◽

Recurrence Risk ◽

Atrial Appendage ◽

Af Recurrence

Objective: The probability of late recurrent atrial fibrillation (AF) after radiofrequency ablation (RFA) has not yet been fully clarified. This study aims to study the association of left atrial appendage (LAA) morphology with AF recurrence after RFA.Methods: We retrospectively enrolled 84 patients (24 patients had persistent AF, 60 patients had paroxysmal AF) who underwent RFA in Shanghai East Hospital from June 2014 to May 2018. The mean follow-up of these patients was 618.6 days. According to preoperative transesophageal echocardiography (TEE), the morphology feature of LAA was classified and evaluated by two classification methods. The first method was divided into chicken-wing, windsock, cactus, and cauliflower, and the second method was divided into one lobe, two lobes, and multiple lobes. The correlation between morphological feature of LAA and the recurrence rate of AF after RFA was analyzed.Results: During follow-up, 12 patients (50%) and 10 patients (16.7%) had AF recurrence in persistent and paroxysmal AF, respectively. The LAA morphology was associated with the recurrence of AF after RFA with the chicken-wing highest recurrence risk (68.2%). The structure type of LAA was also related to the AF recurrence rate (p < 0.01). Compared with one lobe and multiple lobes, two lobes (recurrence, 47.6%) were more likely associated with the recurrence of AF (p < 0.02). Logistic regression analysis showed that the chicken-wing group had a higher risk of recurrence after RFA (OR = 8.13, p = 0.004), and the windsock group had a lower risk of recurrence (OR = 0.17, p = 0.002).Conclusion: The morphological feature of LAA is related to the recurrence risk of AF after RFA. LAA morphology assessment can predict the risk of AF recurrence.

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Concealed Pulmonary Vein Bigeminy during Sinus Rhythm in Patients with Paroxysmal Atrial Fibrillation: A Useful Marker for Pulmonary Vein Firing

Cardiology Research and Practice ◽

10.1155/2018/1834514 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6

Author(s):

Jiqiang Hu ◽

Wu Kuang ◽

Xiaoyun Cui ◽

Yan Li ◽

Yang Wu ◽

...

Keyword(s):

Atrial Fibrillation ◽

Sinus Rhythm ◽

Success Rate ◽

Pulmonary Vein ◽

Recurrence Rate ◽

Paroxysmal Atrial Fibrillation ◽

Coupling Interval ◽

Ablation Success

Introduction. A concealed pulmonary vein (PV) bigeminy (cPVB) may be found in some patients with atrial fibrillation (AF) during sinus rhythm (SR). The aim of this study was to investigate whether the presence of cPVB during SR is associated with a higher PV firing. Methods and Results. Seven hundred seventy-six PVs (excluding 5 right middle PVs and 8 left common trunks) were mapped in 198 patients with paroxysmal AF (PAF) who underwent circumferential PV isolation. cPVB with a mean coupling interval of 136 ± 16 ms during SR was observed prior to ablation in 22 (11%) patients. Focal firing was provoked prior to ablation in 144 (19%) PVs. The incidence of focal firing was greater in PVs exhibiting cPVB compared with PVs without cPVB (89% vs. 16%; P<0.001). Also, the number of radiofrequency applications required for isolation was greater in ipsilateral PVs, exhibiting cPVB compared with ipsilateral PVs without cPVB (21.6 ± 6.8 vs. 18.2 ± 5.6; P=0.024). During a follow-up of 32 ± 20 months, the single ablation success rate was 82%. Compared with patients without cPVB, patients with cPVB were associated with higher recurrence rate of AF (27% vs. 17%; p=0.032). Conclusion. cPVB during SR was observed prior to index ablation in 11% of PAF patients. Such a potential itself may be a PV firing in a concealed manner, which does not reactivate LA. The PV exhibiting cPVB required a greater number of radiofrequency applications for isolation. Compared to patients without cPVB, the recurrence rate of AF in patients with cPVB was greater.

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