Radiofrequency Catheter Ablation of Accessory Pathways During Entrainment of AV Reentrant Tachycardia
Identifieur interne : 004220 ( Main/Exploration ); précédent : 004219; suivant : 004221Radiofrequency Catheter Ablation of Accessory Pathways During Entrainment of AV Reentrant Tachycardia
Auteurs : Huagui G. Li [Canada] ; George J. Klein [Canada] ; Margo Zardini [Canada] ; Ranjan K. Thakur [Canada] ; Garlos A. Morillo [Canada] ; Raymond Yee [Canada]Source :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1994-04.
English descriptors
Abstract
Radiofrequency ablation of accessory pathways must sometimes be done during orthodromic atrioventricular reentrant tachycardia when manifest anterograde accessory pathway conduction is absent or retrograde fusion obscures accessory pathway location during ventricular pacing. Unfortunately, abrupt heart rate slowing upon radiofrequency induced termination of atrioventricular reentrant tachycardia often causes catheter dislodgment. We report our experience in circumventing this problem during radiofrequency ablation by using entrainment of atrioventricular reentrant tachycardia. The latter maintains retrograde activation pattern over the accessory pathway while preventing abrupt ventricular rate change. Eight patients (4 men and 4 women, mean age 37.3 ± 17.9) with eleven left‐sided accessory pathways were included. Ablation during entrainment was used as the first approach in three patients with concealed accessory pathways and one patient with a bidirectional accessory pathway. In another four patients, ablation during entrainment was used after technical difficulties in ablating during tachycardia. Only 1–3 radiofrequency applications were required to eliminate the accessory pathway using the entrainment technique. The catheter remained stable when accessory pathway conduction was interrupted by radiofrequency current. In conclusion, entrainment of atrioventricular reentrant tachycardia during radiofrequency application is useful for maintaining catheter position for accessory pathway ablation during atrioventricular reentrant tachycardia.
Url:
DOI: 10.1111/j.1540-8159.1994.tb02395.x
Affiliations:
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Li</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Arrhythmia Service, Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Arrhythmia Service, Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation><affiliation wicri:level="1"><country>Canada</country><wicri:regionArea>Address for reprints: George J. Klein, M.D., University Hospital. 339 Windermere Rd., London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Zardini, Margo" sort="Zardini, Margo" uniqKey="Zardini M" first="Margo" last="Zardini">Margo Zardini</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Arrhythmia Service, Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Thakur, Ranjan K" sort="Thakur, Ranjan K" uniqKey="Thakur R" first="Ranjan K." last="Thakur">Ranjan K. Thakur</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Arrhythmia Service, Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Morillo, Garlos A" sort="Morillo, Garlos A" uniqKey="Morillo G" first="Garlos A." last="Morillo">Garlos A. Morillo</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Arrhythmia Service, Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author><author><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Arrhythmia Service, Department of Medicine, University of Western Ontario, London, Ontario</wicri:regionArea><wicri:noRegion>Ontario</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1994-04">1994-04</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="590">590</biblScope><biblScope unit="page" to="594">594</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">7109FF73CDD97AF52506EEEDB8C773FAE85EBC6A</idno><idno type="DOI">10.1111/j.1540-8159.1994.tb02395.x</idno><idno type="ArticleID">PACE590</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>atrioventricular reentrant tachycardia</term><term>entrainment</term><term>radiofrequency ablation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Radiofrequency ablation of accessory pathways must sometimes be done during orthodromic atrioventricular reentrant tachycardia when manifest anterograde accessory pathway conduction is absent or retrograde fusion obscures accessory pathway location during ventricular pacing. Unfortunately, abrupt heart rate slowing upon radiofrequency induced termination of atrioventricular reentrant tachycardia often causes catheter dislodgment. We report our experience in circumventing this problem during radiofrequency ablation by using entrainment of atrioventricular reentrant tachycardia. The latter maintains retrograde activation pattern over the accessory pathway while preventing abrupt ventricular rate change. Eight patients (4 men and 4 women, mean age 37.3 ± 17.9) with eleven left‐sided accessory pathways were included. Ablation during entrainment was used as the first approach in three patients with concealed accessory pathways and one patient with a bidirectional accessory pathway. In another four patients, ablation during entrainment was used after technical difficulties in ablating during tachycardia. Only 1–3 radiofrequency applications were required to eliminate the accessory pathway using the entrainment technique. The catheter remained stable when accessory pathway conduction was interrupted by radiofrequency current. In conclusion, entrainment of atrioventricular reentrant tachycardia during radiofrequency application is useful for maintaining catheter position for accessory pathway ablation during atrioventricular reentrant tachycardia.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Li, Huagui G" sort="Li, Huagui G" uniqKey="Li H" first="Huagui G." last="Li">Huagui G. Li</name></noRegion><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name><name sortKey="Morillo, Garlos A" sort="Morillo, Garlos A" uniqKey="Morillo G" first="Garlos A." last="Morillo">Garlos A. Morillo</name><name sortKey="Thakur, Ranjan K" sort="Thakur, Ranjan K" uniqKey="Thakur R" first="Ranjan K." last="Thakur">Ranjan K. Thakur</name><name sortKey="Yee, Raymond" sort="Yee, Raymond" uniqKey="Yee R" first="Raymond" last="Yee">Raymond Yee</name><name sortKey="Zardini, Margo" sort="Zardini, Margo" uniqKey="Zardini M" first="Margo" last="Zardini">Margo Zardini</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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