Document Detail

Role of catheter-induced mechanical trauma in localization of target sites of radiofrequency ablation in automatic atrial tachycardia.
MedLine Citation:
PMID:  8609326     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We compared the efficacy of two different mapping techniques in identifying the ablation site for atrial tachycardia. Moreover, we evaluated the additive positive predictive value of mechanical interruption of atrial tachycardia to reduce the number of ineffective radiofrequency applications. BACKGROUND: Radiofrequency catheter ablation has been suggested as a highly effective technique to treat drug-resistant atrial tachycardia. However, irrespective of the mapping technique utilized, success was most often achieved with a large number of radiofrequency applications. METHODS: Forty-five patients with atrial tachycardia underwent radiofrequency catheter ablation. Mapping techniques included identification of earliest atrial activation and pace-mapping concordant sequence. RESULTS: Atrial tachycardia was successfully treated in 42 (93.3%) of 45 patients with a mean of 3.9 radiofrequency pulses/patient. An interval between the onset of the intracavitary atrial deflection and the onset of the P wave during atrial tachycardia (AP interval) > or = 30 ms (p < 0.001) and pace-mapping concordant sequence (p = 0.01) were all significant predictors of outcome. An AP interval > or = 30 ms and a pace-mapping concordant sequence were highly sensitive (92.8%, 95% confidence interval [CI] 80.5% to 98.5%; 85.7%, 95% CI 71.5% to 94.6%, respectively) but less specific (47.8%, 95% CI 37.9% to 58.2%, 36.8%, 95% CI 27.6% to 47.2%, respectively) in identifying the site of ablation. By using atrial tachycardia mechanical interruption combined with the AP interval >30 ms or the pace-mapping concordant sequence, we obtained a specifically of 76.5% (95% CI 66.4% to 84.0%) and 73.5% (95% CI 63.2% to 81.4%), respectively, and a positive predictive value of 49.2% and 44.6%, respectively. CONCLUSIONS: An AP interval > or = 30 ms and a pace-mapping concordant sequence were reliable mapping features for predicting the outcome of the ablation procedure. Mechanical interruption of atrial tachycardia improved the specificity and positive predictive value of these two mapping techniques.
C Pappone; G Stabile; A De Simone; G Senatore; P Turco; M Damiano; D Iorio; N Spampinato; M Chiariello
Related Documents :
9581956 - Temperature-controlled irrigated tip radiofrequency catheter ablation: comparison of in...
12410936 - Erosion of a penile prosthesis due to an indwelling urethral catheter as a late complic...
9448676 - Reentrant tachycardias. a look at where treatment stands today.
9260016 - Light-guided retrograde intubation.
23351826 - Aborted myocardial infarction after primary percutaneous coronary intervention: magneti...
9216436 - Ace inhibition reduces left ventricular mass independent of pressure without affecting ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  27     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-05-30     Completed Date:  1996-05-30     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1090-7     Citation Subset:  AIM; IM    
Department of Cardiology and Cardiac Surgery, Medical School, Federico II University, Naples, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Catheter Ablation / methods*
Middle Aged
Predictive Value of Tests
Tachycardia, Supraventricular / physiopathology,  surgery*

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

Previous Document:  Conversion of atrial flutter by ibutilide is associated with increased atrial cycle length variabili...
Next Document:  Posterior fast atrioventricular node pathways: implications for radiofrequency catheter ablation of ...