scholarly journals Radiofrequency Catheter Ablation for Supraventricular Tachycardias: A Six-Year Single Centre Experience at NICVD

2021 ◽  
Vol 36 (2) ◽  
pp. 68-73
Author(s):  
Md Mustafizur Rahman ◽  
Md Mohsin Hossain ◽  
Asif Zaman Tushar ◽  
Al Mamun ◽  
Md Nazmul Haq ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Underlying Mechanism ◽  
Pharmacological Therapy ◽  
Electrophysiology Study ◽  
Highly Effective ◽  
Focal Atrial Tachycardia ◽  
Supraventricular Tachyarrhythmias ◽  
Supraventricular Tachycardias

Pharmacological therapy is mostly employed in the management of supraventricular tachyarrhythmias in different part of the world including Bangladesh. However, Radiofrequency catheter ablation has been found to be highly effective and safe in the treatment of such tachyarrhythmias. Objective: The current study is aimed at sharing our experiences of 842 patients who presented with Supraventricular tachycardias and were diagnosed by EPS and treated with Radiofrequency catheter ablation. Methods: This descriptive study has been carried out in the cardiac electro physiology Department of NICVD, Dhaka, Bangladesh from 2nd January 2015 to 31st December, 2020. Electrophysiology study(EPS) was carried out to identity and diagnose the mechanism of different SVTs in 842 consecutive patients. RF catheter ablation was used to interrupt the tachycardia circuit. Results: Out of a total 842 patients who underwent Electrophysiology study, 435 were found to have atrioventricular nodal re-entry tachycardia (AVNRT) as underlying mechanism and 391 were having accessory pathway responsible for the reentry mechanism; of these accessory mediated tachycardia, 250 patients were manifested accessory pathway (WPWS); 141 were concealed accessory pathway (out of them 365 were presented with orthodromic and 26 as antidromic reciprocating tachycardia); moreover among the accessory pathway 231 patients were found having left sided accessory pathway whereas 155 having right sided pathway; 12 patients were having focal atrial tachycardia and 4 were found atrial flutter as the underlying cause for SVT. Radiofrequency catheter ablation was used with an overall success rate of 95%, recurrence rate of 2% without any significant complication. Complication: One patient developed pulmonary thrombo-embolism, 6 patients developed DVT of right lower limb, 4 patients developed complete heart block. Conclusion: RF catheter ablation is safe and highly effective mode of treatment of different types of supraventricular tachyarrhythmias which is emerging and becoming popular in our country. Bangladesh Heart Journal 2021; 36(2): 68-73

Is routine echocardiography valuable after uncomplicated catheter ablation in children?

2004 ◽  
Vol 14 (4) ◽  
pp. 386-388 ◽  
Author(s):  
Janneke A. E. Kammeraad ◽  
Narayanswami Sreeram ◽  
Vincent van Driel ◽  
Ron Oliver ◽  
Seshadri Balaji
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrial Tachycardia ◽  
Aortic Insufficiency ◽  
Clinical Value ◽  
Transthoracic Doppler Echocardiography ◽  
Asymptomatic Patients ◽  
Before And After ◽  
Focal Atrial Tachycardia ◽  
Supraventricular Tachyarrhythmias

We determined the clinical value of routine transthoracic echocardiography performed after catheter ablation of supraventricular tachyarrhythmias in children. Between April 1996 and December 2003, 253 children, of whom 135 male, with the overall group having a median age of 9, ranging from 0.1 to 19 years, underwent 280 uncomplicated radiofrequency catheter ablation procedures for supraventricular tachyarrhythmias at three institutions. In every child, transthoracic Doppler echocardiography was performed before and after the procedure. The pre-ablation transthoracic echocardiograms were normal in all, and this was one of the criterions for inclusion. The post-ablation echocardiogram showed a disorder in four asymptomatic patients. In one patient, with focal atrial tachycardia, ablated via a retrograde aortic approach, there was mild aortic valvar insufficiency. This had resolved 6 months later. Pericardial effusions developed in 3 other children. In 2 the effusions resolved spontaneously but 1 patient required pericardial drainage. This same patient also developed clinically asymptomatic mild aortic insufficiency, which resolved spontaneously within 6 months. Routine echocardiography after uncomplicated catheter ablation procedures is of clinical value, and is especially indicated when a retrograde aortic approach has been used.

Radiofrequency catheter ablation for the treatment of supraventricular tachycardias in children and adolescents

2000 ◽  
Vol 10 (4) ◽  
pp. 376-383 ◽  
Author(s):  
Pedro Iturralde ◽  
Luís Colín ◽  
Sergio Kershenovich ◽  
Milton E. Guevara ◽  
Argelia Medeiros ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Atrial Flutter ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Atrioventricular Node ◽  
Slow Pathway ◽  
Accessory Pathways ◽  
Children And Young Adults ◽  
Supraventricular Tachycardias ◽  
Fast Pathway

AbstractWe report our experience in radiofrequency catheter ablation between April, 1992 and December, 1998, in which we treated 287 parients less than 18 years of age (mean 14.3±3.1 years) with supraventricular tachycardia. Accessory pathways were the arrhythmic substrate in 252 of the patients (87.8%), the patients having a total of 265 accessory pathways. Atrioventricular nodal re-entry was the cause of tachycardia in 26 patients (9.0%), while atrial flutter was detected in the remaining 9 patients (3.1%). We were able successfully to eliminate the accessory pathway in 236 patients (89%), but 25 patients had recurrent arrhythmias. Ablation proved successful in all cases of atrioventricular node re-entry tachycardia, the slow pathway being ablated in 25 patients, and the fast pathway in only one case. Recurrence of the arrhythmia occurred in three patients (11.5%). We performed a second ablation in these children, all then proving successful. The ablation was successful in all cases of atrial flutter, with one recurrence (11.1%). Overall, therefore, ablation was immediately successful in 271 patients (94.4%), with a recurrence of the arrhythmia in 29 cases (10.7%). The incidence of serious complications was 2.09% There was one late death due to infective endocarditis, 3 patients suffered complete heart block, 1 had mild mitral regurgitation, and 1 patient developed an haematoma in the groin. We conclude that radiofrequency catheter ablation can now be considered a standard option for the management of paroxysmal supraventricular tachycardias in children and young adults.

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.

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.

Radiofrequency Catheter Ablation of an Accessory Pathway in Dextrocardia

1997 ◽  
Vol 20 (9) ◽  
pp. 2284-2285 ◽  
Author(s):  
HARUHIKO ABE ◽  
MASARU ARAKI ◽  
TOSHIHISA NAGATOMO ◽  
YASUSHI MIURA ◽  
YASUHIDE NAKASHIMA
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway

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.

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