Document Detail

Hemodynamic deterioration following radiofrequency ablation of the atrioventricular conduction system.
MedLine Citation:
PMID:  9358483     Owner:  NLM     Status:  MEDLINE    
Radiofrequency ablation of the atrioventricular conduction system (ACS) has become an established therapy for patients with drug refractory atrial fibrillation. We observed eight patients with hemodynamic deterioration after radiofrequency ablation of the atrioventricular conduction system. As we found hemodynamic deterioration related to worsening mitral regurgitation, we compared the clinical history, electrophysiological, and echocardiographic data from the patients with hemodynamic deterioration and worsening mitral regurgitation (group 1) to those without hemodynamic deterioration and stable mitral regurgitation after the procedure (group 2). Eight out of 108 patients (7.4%) undergoing ablation of the ACS deteriorated hemodynamically with acute pulmonary edema in three and congestive heart failure in five patients occurring at a mean of 3 and 8 weeks, respectively, after the procedure. Three of these patients were referred for mitral valve surgery. Two patients underwent ablation using a left-sided approach. A right-sided approach was used in five patients. In one patient, a left- and right-sided approach was used. Compared to group 2 patients, group 1 patients had significantly higher left ventricular end-diastolic diameters (64 +/- 6 mm vs 56 +/- 9 mm) at baseline despite similar fractional shortening (32% +/- 11% vs 34% +/- 13%), left ventricular end-systolic diameters (43 +/- 9 mm vs 36 +/- 7 mm) and degree of mitral regurgitation (1.4 +/- 1.1 vs 1.4 +/- 0.7) on echocardiographic analysis. Thus, hemodynamic deterioration together with progression of mitral regurgitation is a potential complication of ablation of the ACS (up to 7.4%). Patients with high left ventricular end-diastolic diameters and moderate mitral regurgitation at baseline seem prone to this complication.
M Vanderheyden; M Goethals; I Anguera; P Nellens; E Andries; J Brugada; P Brugada
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  20     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1997 Oct 
Date Detail:
Created Date:  1997-12-19     Completed Date:  1997-12-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2422-8     Citation Subset:  IM    
Cardiovascular Center, O.L.V. Ziekenhuis, Aalst, Belgium.
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MeSH Terms
Aged, 80 and over
Atrial Fibrillation / complications,  surgery*
Atrioventricular Node / surgery*
Cardiac Output, Low / etiology
Catheter Ablation / adverse effects*
Disease Progression
Heart Failure / etiology*,  physiopathology
Middle Aged
Mitral Valve Insufficiency / complications,  ultrasonography
Pacemaker, Artificial
Retrospective Studies
Comment In:
Pacing Clin Electrophysiol. 2005 May;28(5):357-60   [PMID:  15869664 ]

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

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