Document Detail


Radiofrequency catheter atrioventricular node ablation in patients with permanent cardiac pacing systems.
MedLine Citation:
PMID:  7511234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Following successful RF ablation of the atrioventricular node (AVN), temporary pacing is necessary prior to insertion of a permanent pacemaker. The risks and inconvenience of temporary pacing could be avoided if a permanent pacemaker is already in place. This study reports the feasibility of RF ablation of the AVN in 27 patients (age 55 +/- 17 years, 15 males) with hypertrophic cardiomyopathy and pacemakers. Indications for AVN ablation were drug refractory atrial fibrillation in 24 patients, and rapid AVN conduction preventing septal pre-excitation by DDD pacemaker, inserted for relief of left ventricular outflow obstruction, in three cases. Sixteen patients had DDD devices and 11 patients had VVI devices. During RF ablation, each pacemaker was programmed to VVI at 50 beats/min. The ablation catheter was manipulated with fluoroscopic control to avoid close contact with or disturbance of the pacing leads. In 16 patients, RF ablation was performed immediately following pacemaker implantation but in the remaining patients, the AVN was ablated 6-32 months after pacemaker implantation. The power applied was 25-50 watts for a duration of 15-60 seconds. AV block was achieved in all cases but required 34 +/- 36 applications for 16.5 +/- 17.8 min/case. RF ablation consistently caused reversion to magnet rate in one patient and temporarily inhibited appropriate pacemaker discharge in another. However, no other pacemaker or lead malfunction was detected so that temporary pacing was not required in any case. At 6 +/- 3 months follow-up, all pacemakers were functioning normally without alteration in pacing parameters from baseline.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A C Chang; D McAreavey; D Tripodi; L Fananapazir
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  17     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-04-28     Completed Date:  1994-04-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  65-9     Citation Subset:  IM    
Affiliation:
Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20892.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / complications*,  epidemiology,  surgery
Atrioventricular Node / surgery*
Cardiac Pacing, Artificial*
Cardiomyopathy, Hypertrophic / complications,  epidemiology,  therapy*
Catheter Ablation*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies

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


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