| Wolff-Parkinson-White ablation after a prior failure: a 7-year multicentre experience. | |
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MedLine Citation:
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PMID: 20223787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: Catheter ablation for Wolff-Parkinson-White syndrome (WPW) can be challenging and is associated with failure in approximately 1-5% of cases. We analysed the reasons for failure. METHODS AND RESULTS: All patients (89 patients, 28 +/- 16 years old) referred for WPW ablation after a prior failure were studied. Reasons for the prior failure as well as for the acute success were analysed. The repeat procedure was successful in 81 (91%) patients. Multiple (2.7 +/- 0.9) or large accessory pathways (APs) were seen in 13 patients. For left lateral APs, inaccurate mapping and lack of transseptal access during the index procedure accounted for failure (n = 15). An irrigated-tip catheter was required for epicardial APs (n = 7). In addition, seven posteroseptal APs required bi-atrial and coronary sinus (CS) applications in order to succeed. For parahisian and midseptal APs, radiofrequency was cautiously titrated from 5 to 30 W, eliminating the AP in three patients. Cryoablation was used in seven patients (acute success in six but delayed recurrences in three of these). For patients with CS AP, irrigated ablation in the CS was crucial to deliver adequate power. For anteroseptal and right lateral APs, a successful outcome was achieved with long sheaths (n = 5) or a left subclavian approach (anteroseptal, n = 4). CONCLUSION: Failure in WPW ablation may be due to a variety of reasons but catheter manipulation and inaccurate mapping remain the two major causes. Knowledge of the reasons for failure depending on the location of the WPW may facilitate a successful outcome. |
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Authors:
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Frederic Sacher; Matthew Wright; Usha B Tedrow; Mark D O'Neill; Pierre Jais; Mélèze Hocini; Rosie Macdonald; D Wyn Davies; Prapa Kanagaratnam; Nicolas Derval; Laurence Epstein; Nicholas S Peters; William G Stevenson; Michel Haissaguerre |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-03-11 |
Journal Detail:
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Title: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology Volume: 12 ISSN: 1532-2092 ISO Abbreviation: Europace Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-08-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883649 Medline TA: Europace Country: England |
Other Details:
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Languages: eng Pagination: 835-41 Citation Subset: IM |
Affiliation:
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CHU de Bordeaux/Université Bordeaux II, Hôpital Cardiologique du Haut-Lévêque, Avenue de Magellan, 33604 Bordeaux-Pessac, France. frederic.sacher@chu-bordeaux.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Atrioventricular Node / physiopathology, surgery Catheter Ablation / methods* Child Coronary Sinus Cryosurgery / methods* Echocardiography Electrocardiography Female Heart Conduction System / physiopathology Heart Septum / physiopathology, surgery Humans Male Recurrence Reoperation* Retrospective Studies Subclavian Artery Treatment Failure Wolff-Parkinson-White Syndrome / physiopathology*, surgery*, ultrasonography Young Adult |
| Comments/Corrections | |
Comment In:
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Europace. 2010 Jun;12(6):772-3
[PMID:
20466814
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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