Efficacy and safety of an irrigated-tip catheter for the ablation of accessory pathways resistant to conventional radiofrequency ablation
Identifieur interne : 003B93 ( Main/Curation ); précédent : 003B92; suivant : 003B94Efficacy and safety of an irrigated-tip catheter for the ablation of accessory pathways resistant to conventional radiofrequency ablation
Auteurs : Teiichi Yamane [France] ; Pierre Jaïs [France] ; Dipen C. Shah [France] ; Mélèze Hocini [France] ; JING TIAN PENG [France] ; Isabel Deisenhofer [France] ; Jacques Clementy [France] ; Michel Haïssaguerre [France]Source :
- Circulation : (New York, N.Y.) [ 0009-7322 ] ; 2000.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme, Irrigation.
English descriptors
- KwdEn :
Abstract
Background-Radiofrequency catheter ablation of accessory pathways (APs) is very effective in all but a minority of patients. We examined the usefulness and safety of irrigated-tip catheters in treating patients with APs resistant to conventional catheter ablation. Methods and Results-Among 314 APs in 301 consecutive patients, conventional ablation failed to eliminate AP conduction in 18 APs in 18 patients (5.7%), 6 of which were located in the left free wall, 5 in the middle/posterior-septal space, and 7 inside the coronary sinus (CS) or its tributaries. Irrigated-tip catheter ablation was subsequently performed with temperature control mode (target temperature, 50°C), a moderate saline flow rate (17 mL/min), and a power limit of 50 W (outside CS) or 20 to 30 W (inside CS) at previously resistant sites. Seventeen of the 18 resistant APs (94%) were successfully ablated with a median of 3 applications using irrigated-tip catheters. A significant increase in power delivery was achieved (20.3 ± 11.5 versus 36.5 ± 8.2 W; P<0.01) with irrigated-tip catheters, irrespective of the AP location, particularly inside the CS or its tributaries. No serious complications occurred. Conclusions-Irrigated-tip catheter ablation is safe and effective in eliminating AP conduction resistant to conventional catheters, irrespective of the location.
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Pascal:01-0036991Le document en format XML
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<author><name sortKey="Haissaguerre, Michel" sort="Haissaguerre, Michel" uniqKey="Haissaguerre M" first="Michel" last="Haïssaguerre">Michel Haïssaguerre</name>
<affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Hôpital Cardiologique du Haut-Lévêque</s1>
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<series><title level="j" type="main">Circulation : (New York, N.Y.)</title>
<title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title>
<idno type="ISSN">0009-7322</idno>
<imprint><date when="2000">2000</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Catheterization</term>
<term>Human</term>
<term>Irrigation</term>
<term>Radiofrequency irradiation</term>
<term>Technique</term>
<term>Toxicity</term>
<term>Treatment</term>
<term>Treatment efficiency</term>
<term>Wolff Parkinson White syndrome</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Wolff Parkinson White syndrome</term>
<term>Homme</term>
<term>Traitement</term>
<term>Cathétérisme</term>
<term>Technique</term>
<term>Irrigation</term>
<term>Efficacité traitement</term>
<term>Toxicité</term>
<term>Irradiation haute fréquence</term>
<term>Voie conduction accessoire</term>
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<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
<term>Irrigation</term>
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<front><div type="abstract" xml:lang="en">Background-Radiofrequency catheter ablation of accessory pathways (APs) is very effective in all but a minority of patients. We examined the usefulness and safety of irrigated-tip catheters in treating patients with APs resistant to conventional catheter ablation. Methods and Results-Among 314 APs in 301 consecutive patients, conventional ablation failed to eliminate AP conduction in 18 APs in 18 patients (5.7%), 6 of which were located in the left free wall, 5 in the middle/posterior-septal space, and 7 inside the coronary sinus (CS) or its tributaries. Irrigated-tip catheter ablation was subsequently performed with temperature control mode (target temperature, 50°C), a moderate saline flow rate (17 mL/min), and a power limit of 50 W (outside CS) or 20 to 30 W (inside CS) at previously resistant sites. Seventeen of the 18 resistant APs (94%) were successfully ablated with a median of 3 applications using irrigated-tip catheters. A significant increase in power delivery was achieved (20.3 ± 11.5 versus 36.5 ± 8.2 W; P<0.01) with irrigated-tip catheters, irrespective of the AP location, particularly inside the CS or its tributaries. No serious complications occurred. Conclusions-Irrigated-tip catheter ablation is safe and effective in eliminating AP conduction resistant to conventional catheters, irrespective of the location.</div>
</front>
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