Document Detail


Cryoablation of junctional tachycardia at high risk of atrio-ventricular block.
MedLine Citation:
PMID:  18477941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Transcatheter cryoablation is an alternative option for the treatment of supraventricular tachycardia, due to its very low risk of permanent atrio-ventricular block. However, the overcost of cryocatheter and the high recurrence rate of this emerging technology braked its large use. This study reports the results of an approach using cryoablation for the treatment of junctional tachycardia (JT) in selected patients at high risk of atrio-ventricular (AV) block.
PATIENTS AND METHODS: Out of a series of 199 patients with JT treated by catheter ablation, 26 benefited from cryoablation (mean age 32.8+/-15 years, 15 males). The indications were the presence of an accessory pathway with a high risk of atrio-ventricular block (n=7), a slow pathway difficult to ablate, with a risk of atrio-ventricular block (n=7), a recurrence after a RF procedure, during which a transient atrio-ventricular block has occurred (n=4), and finally patients at young age (n=8).
RESULTS: The primary success rate was 92%. No permanent AV block has been reported, neither with RF nor with cryoablation. The recurrence rate at 9+/-10 months was at 29% after cryoablation and 8.6% after RF. In case of AV nodal reentrant tachycardia, the additional cost of cryotherapy catheter has been avoided in 76.85% of cases. The use of a cryotherapy catheter and RF catheter has been necessary for the remaining cases.
CONCLUSION: This study demonstrates that an approach, reserving cryoablation in selected patients at high risk of AV block is an alternative strategy to "the systematic use" of cryotherapy in the ablation of JT with a high efficacy, an excellent safety and a reduced cost.
Authors:
G Nadji; J-S Hermida; M Kubala; S Quenum; H Bakkour; G Jarry
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  101     ISSN:  1875-2136     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-05-14     Completed Date:  2008-09-16     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  149-54     Citation Subset:  IM    
Affiliation:
Service de cardiologie, Centre hospitalier universitaire d'Amiens-Picardie, Avenue René-Laennec, Amiens cedex. nadji.georges@free.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Atrioventricular Block / etiology,  physiopathology,  prevention & control*
Atrioventricular Node / physiopathology,  surgery*
Cryosurgery / methods*
Electrocardiography
Female
Follow-Up Studies
Heart Catheterization
Heart Rate / physiology
Humans
Male
Retrospective Studies
Risk Factors
Severity of Illness Index
Tachycardia, Ectopic Junctional / complications,  physiopathology,  surgery*
Treatment Outcome
Comments/Corrections
Comment In:
Arch Cardiovasc Dis. 2008 Mar;101(3):137-8   [PMID:  18477938 ]

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