Radiofrequency catheter ablation of accessory pathways: A learning experience
Identifieur interne : 004759 ( Main/Exploration ); précédent : 004758; suivant : 004760Radiofrequency catheter ablation of accessory pathways: A learning experience
Auteurs : Richard A. Leather [Canada] ; James W. Leitch [Canada] ; George J. Klein [Canada] ; Gerard M. Guiraudon [Canada] ; Raymond Yee [Canada] ; You Ho Kim [Canada]Source :
- The American Journal of Cardiology [ 0002-9149 ] ; 1991.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Accessory bundle, Adolescent, Adult, Aged, Atrial Fibrillation (surgery), Atrioventricular Node (innervation), Atrioventricular Node (physiopathology), Atrioventricular Node (surgery), Catheterization, Child, Conduction disorder, Creatine Kinase (blood), Electrocardiography, Electrocoagulation, Electrocoagulation (adverse effects), Electrocoagulation (methods), Female, Follow-Up Studies, Heart, Human, Humans, Instrumentation therapy, Isoenzymes, Male, Middle Aged, Myocardial Infarction (blood), Radiofrequency, Reoperation, Tachycardia, Supraventricular (surgery), Technique, Wolff Parkinson White syndrome, Wolff-Parkinson-White Syndrome (physiopathology), Wolff-Parkinson-White Syndrome (surgery).
- MESH :
- chemical , blood : Creatine Kinase.
- adverse effects : Electrocoagulation.
- blood : Myocardial Infarction.
- innervation : Atrioventricular Node.
- methods : Electrocoagulation.
- physiopathology : Atrioventricular Node, Wolff-Parkinson-White Syndrome.
- surgery : Atrial Fibrillation, Atrioventricular Node, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome.
- Adolescent, Adult, Aged, Child, Electrocardiography, Female, Follow-Up Studies, Humans, Isoenzymes, Male, Middle Aged, Reoperation.
Abstract
Success rates of approximately 90% have recently been reported with radiofrequency catheter ablation of accessory pathways. This study determined whether this success could be repeated using a conservative approach generally limiting fluoroscopy time to 1 hour. Consecutive patients referred for management of arrhythmias associated with accessory atrioventricular pathways were included over a 9-month period. Ablation was attempted in 75 patients with 84 pathways. Overall success rate (including second attempts in 9 patients) was 60 of 84 accessory pathways (71%). Success rates for the first 3 months (n = 23) were 52%, the second 3 months (n = 23) 60% and the last 3 months (n = 38) 90%. Success rate varied with pathway location, with left lateral pathways having the best early success rates. Mean fluoroscopy time for successful procedures of 33 ± 21 minutes was shorter than the time for unsuccessful procedures of 63 ± 24 minutes (p = 0.001). There were no major complications and no patients with successful procedures (n = 53) have had recurrence of accessory pathway conduction or reciprocating tachycardia (follow-up 1 to 10 months). A conservative approach can yield success rates approaching 90% in a short time. The absence of major complications supports earlier reports suggesting that radiofrequency catheter ablation of accessory pathways is a reasonable first-line therapy in the Wolfff-Parkinson-White syndrome.
Url:
DOI: 10.1016/0002-9149(91)90324-E
Affiliations:
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Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accessory bundle</term>
<term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Atrial Fibrillation (surgery)</term>
<term>Atrioventricular Node (innervation)</term>
<term>Atrioventricular Node (physiopathology)</term>
<term>Atrioventricular Node (surgery)</term>
<term>Catheterization</term>
<term>Child</term>
<term>Conduction disorder</term>
<term>Creatine Kinase (blood)</term>
<term>Electrocardiography</term>
<term>Electrocoagulation</term>
<term>Electrocoagulation (adverse effects)</term>
<term>Electrocoagulation (methods)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Heart</term>
<term>Human</term>
<term>Humans</term>
<term>Instrumentation therapy</term>
<term>Isoenzymes</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Myocardial Infarction (blood)</term>
<term>Radiofrequency</term>
<term>Reoperation</term>
<term>Tachycardia, Supraventricular (surgery)</term>
<term>Technique</term>
<term>Wolff Parkinson White syndrome</term>
<term>Wolff-Parkinson-White Syndrome (physiopathology)</term>
<term>Wolff-Parkinson-White Syndrome (surgery)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Creatine Kinase</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electrocoagulation</term>
</keywords>
<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Myocardial Infarction</term>
</keywords>
<keywords scheme="MESH" qualifier="innervation" xml:lang="en"><term>Atrioventricular Node</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electrocoagulation</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Atrioventricular Node</term>
<term>Wolff-Parkinson-White Syndrome</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Atrial Fibrillation</term>
<term>Atrioventricular Node</term>
<term>Tachycardia, Supraventricular</term>
<term>Wolff-Parkinson-White Syndrome</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Child</term>
<term>Electrocardiography</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Isoenzymes</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Reoperation</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Cathétérisme</term>
<term>Coeur</term>
<term>Electrocoagulation</term>
<term>Faisceau accessoire</term>
<term>Homme</term>
<term>Radiofréquence</term>
<term>Technique</term>
<term>Traitement instrumental</term>
<term>Trouble conduction</term>
<term>Wolff Parkinson White syndrome</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
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<front><div type="abstract" xml:lang="en">Success rates of approximately 90% have recently been reported with radiofrequency catheter ablation of accessory pathways. This study determined whether this success could be repeated using a conservative approach generally limiting fluoroscopy time to 1 hour. Consecutive patients referred for management of arrhythmias associated with accessory atrioventricular pathways were included over a 9-month period. Ablation was attempted in 75 patients with 84 pathways. Overall success rate (including second attempts in 9 patients) was 60 of 84 accessory pathways (71%). Success rates for the first 3 months (n = 23) were 52%, the second 3 months (n = 23) 60% and the last 3 months (n = 38) 90%. Success rate varied with pathway location, with left lateral pathways having the best early success rates. Mean fluoroscopy time for successful procedures of 33 ± 21 minutes was shorter than the time for unsuccessful procedures of 63 ± 24 minutes (p = 0.001). There were no major complications and no patients with successful procedures (n = 53) have had recurrence of accessory pathway conduction or reciprocating tachycardia (follow-up 1 to 10 months). A conservative approach can yield success rates approaching 90% in a short time. The absence of major complications supports earlier reports suggesting that radiofrequency catheter ablation of accessory pathways is a reasonable first-line therapy in the Wolfff-Parkinson-White syndrome.</div>
</front>
</TEI>
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<name sortKey="Guiraudon, Gerard M" sort="Guiraudon, Gerard M" uniqKey="Guiraudon G" first="Gerard M." last="Guiraudon">Gerard M. Guiraudon</name>
<name sortKey="Kim, You Ho" sort="Kim, You Ho" uniqKey="Kim Y" first="You Ho" last="Kim">You Ho Kim</name>
<name sortKey="Klein, George J" sort="Klein, George J" uniqKey="Klein G" first="George J." last="Klein">George J. Klein</name>
<name sortKey="Leitch, James W" sort="Leitch, James W" uniqKey="Leitch J" first="James W." last="Leitch">James W. Leitch</name>
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