Document Detail

A randomized comparison of the right- and left-sided approaches to ablation of the atrioventricular junction.
MedLine Citation:
PMID:  8256735     Owner:  NLM     Status:  MEDLINE    
Radiofrequency ablation of the atrioventricular (AV) junction may be performed using either a right- or left-sided approach. This study prospectively compared the left-sided approach with persistent attempts from the right side in patients in whom initial radiofrequency applications on the right side were unsuccessful. Twenty-one of 54 patients did not have complete AV block induced after 3 right-sided radiofrequency applications. These 21 patients were randomly assigned to undergo either the left-sided approach (n = 10) or to undergo additional attempts from the right side (n = 11). The right-sided approach was performed by positioning the ablation catheter to record the largest possible atrial and His bundle electrograms. The left-sided approach was performed by positioning the ablation catheter along the left ventricular septum, where a His bundle potential was recorded. If either approach was not successful after an additional 17 radiofrequency applications, the alternative approach was then used. The AV junction was successfully ablated in all 10 patients randomized to the left-sided approach, but in only 6 of 11 patients randomized to persistent right-sided attempts (p < 0.05). The 5 patients in whom the AV junction was not successfully ablated using the right-sided approach underwent the left-sided approach and had a successful outcome after a mean of 1.2 +/- 0.4 radiofrequency applications. The left-sided approach required significantly fewer radiofrequency applications after randomization than the right-sided approach (3 +/- 3.4 vs 11 +/- 7.6, p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
S J Kalbfleisch; B Williamson; K C Man; V Vorperian; J D Hummel; H Calkins; S A Strickberger; J J Langberg; F Morady
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  72     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-01-12     Completed Date:  1994-01-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1406-10     Citation Subset:  AIM; IM    
Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0022.
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MeSH Terms
Atrioventricular Node / physiopathology,  surgery*
Catheter Ablation / adverse effects,  methods*
Confounding Factors (Epidemiology)
Middle Aged
Prospective Studies
Tachycardia, Supraventricular / surgery

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

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