Document Detail


Radiofrequency catheter ablation for treatment of bundle branch reentrant ventricular tachycardia: results and long-term follow-up.
MedLine Citation:
PMID:  1960328     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Seven of 120 consecutive patients with inducible sustained ventricular tachycardia (from September 1, 1988 to January 1, 1991) had bundle branch reentrant tachycardia and underwent percutaneous radiofrequency ablation of the right bundle branch. The seven patients had been unsuccessfully treated with a mean of 3 +/- 1 drugs. Four patients presented with syncope and three with aborted sudden death. The baseline electrocardiogram revealed a left bundle branch block pattern in three patients and an intraventricular conduction defect in four. The baseline HV interval was prolonged in each case (79 +/- 2 ms). With use of programmed ventricular extrastimuli, sustained bundle branch reentrant tachycardia was inducible in all patients at a mean cycle length of 283 +/- 17 ms (range 230 to 350). Bundle branch reentrant tachycardia characteristics included atrioventricular dissociation, a His deflection that preceded each QRS complex and spontaneous His to His variation that preceded changes in ventricular tachycardia cycle length. A quadripolar catheter was positioned across the tricuspid valve with the distal electrode tip of the catheter near the right bundle branch. One to three applications of continuous unmodulated radiofrequency current at 300 kHz between the distal electrode and a large posterior skin patch resulted in complete right bundle branch block in all patients, after which none had inducible bundle branch reentrant tachycardia on restudy. On restudy, three of the seven patients had ventricular tachycardia of myocardial origin (not bundle branch reentry). One patient required no therapy; drug or defibrillator therapy was used in the others.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
T J Cohen; W W Chien; K G Lurie; C Young; H R Goldberg; Y S Wang; J J Langberg; M D Lesh; M A Lee; J C Griffin
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  18     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-03     Completed Date:  1992-01-03     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1767-73     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of California, San Francisco 94143.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bundle-Branch Block / complications,  diagnosis,  surgery*
Electrocardiography
Electrocoagulation / instrumentation,  methods,  standards*
Electrophysiology
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Radio Waves*
Recurrence
Stroke Volume
Tachycardia / diagnosis,  epidemiology,  etiology*
Grant Support
ID/Acronym/Agency:
HL08174/HL/NHLBI NIH HHS

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


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