Document Detail


Catheter ablation from right atrium of anteroseptal accessory pathways using radiofrequency current.
MedLine Citation:
PMID:  1538026     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Catheter ablation with radiofrequency current has recently been introduced as a therapeutic regimen for symptomatic patients with the Wolff-Parkinson-White syndrome or atrioventricular (AV) tachycardia mediated by a retrogradely conducting (concealed) accessory AV pathway. These pathways may be located, although infrequently, in the anteroseptal region of the heart in close proximity to the AV node-His bundle conduction system. Any attempt to interrupt an anteroseptal accessory pathway therefore is subject to the potential complication of inadvertent impairment of normal AV conduction. This study was conducted to establish whether abolition of anteroseptal accessory pathways by radiofrequency current aimed at the atrial as opposed to the ventricular insertion of the pathway can be achieved with preservation of AV node-His bundle conduction. Twelve patients (mean age 37 +/- 13 years; 10 with Wolff-Parkinson-White syndrome, 2 with a concealed accessory pathway) were studied. In the majority of patients, radiofrequency current (500 kHz; mean energy 577 +/- 207 J) was applied through a steerable catheter with a long tip electrode placed in the anterior septal space at the atrial aspect of the tricuspid anulus, with the intention to destroy the atrial insertion of the accessory pathway. All pathways were successfully ablated. The AV node or His bundle conduction was not impaired in any patient. Right bundle branch block was induced in two patients (17%). There were no complications related to the procedure. It is concluded that catheter ablation from the right atrium using radiofrequency current provides effective and safe interruption of anteroseptal accessory pathways with good preservation of the normal conduction system.
Authors:
M Schlüter; K H Kuck
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  19     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-03-31     Completed Date:  1992-03-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  663-70     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, University Hospital Eppendorf, Hamburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angiography
Electrocoagulation / instrumentation*,  methods
Evaluation Studies as Topic
Female
Follow-Up Studies
Heart Atria
Heart Conduction System / surgery*
Humans
Male
Middle Aged
Radio Waves / therapeutic use*
Treatment Outcome
Wolff-Parkinson-White Syndrome / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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