Treatment of rhythm disorders by endocardial fulguration
Identifieur interne : 005189 ( Main/Exploration ); précédent : 005188; suivant : 005190Treatment of rhythm disorders by endocardial fulguration
Auteurs : Guy Fontaine [France] ; Robert Frank [France] ; Joelci Tonet [France] ; Isabelle Rougier [France] ; Gérard Farenq [France] ; Yves Grosgogeat [France]Source :
- The American Journal of Cardiology [ 0002-9149 ] ; 1989.
English descriptors
- KwdEn :
- MESH :
- physiopathology : Atrioventricular Node, Tachycardia.
- surgery : Arrhythmias, Cardiac, Bundle of His, Endocardium, Tachycardia, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome.
- Electrocoagulation, Humans.
Abstract
The fulguration procedure was originally introduced for the treatment of supraventricular arrhythmias by a pervenous interruption of His bundle conduction. This procedure has been extended to the treatment of almost any cardiac arrhythmia resistant to antiarrhythmic drug therapy. Recent results suggest that ablation could be selectively applied to the site of abnormal conduction. Overall results obtained at the Jean Rostand Hospital are reported for a series of 104 patients ranging in age from 14 to 83 years with atrial, junctional and ventricular tachycardias. The follow-up extends up to 65 months. Clinical efficacy, defined as a control of the arrhythmias by Fulguration used alone or in association with drug therapy that was previously ineffective, lead to a success rate ranging from 80 to 85%. Mortality was less than 10% in the worst situation (chronic resistant ventricular tachycardia). Mortality was always related to inappropriate protocols. Therefore, fulguration, which was originally reserved to treat the most difficult cases, is now considered for non-life-threatening but incapacitating arrhythmias.Despite these results the technique is not simple. Fulguration should be performed by groups knowledgeable in electrophysiology and with expertise in high voltage electricity and biophysics.
Url:
DOI: 10.1016/0002-9149(89)91207-1
Affiliations:
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last="Fontaine">Guy Fontaine</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Service de Rythmologie et de Stimulation Cardiaque, Hôpital Jean Rostand, 39 rue Jean le Galleu, 94200 Ivry</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Ivry</settlement></placeName></affiliation></author><author><name sortKey="Frank, Robert" sort="Frank, Robert" uniqKey="Frank R" first="Robert" last="Frank">Robert Frank</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Service de Rythmologie et de Stimulation Cardiaque, Hôpital Jean Rostand, 39 rue Jean le Galleu, 94200 Ivry</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Ivry</settlement></placeName></affiliation></author><author><name sortKey="Tonet, Joelci" sort="Tonet, Joelci" uniqKey="Tonet J" first="Joelci" last="Tonet">Joelci Tonet</name><affiliation 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(surgery)</term><term>Tachycardia, Supraventricular (surgery)</term><term>Wolff-Parkinson-White Syndrome (surgery)</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Atrioventricular Node</term><term>Tachycardia</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Arrhythmias, Cardiac</term><term>Bundle of His</term><term>Endocardium</term><term>Tachycardia</term><term>Tachycardia, Supraventricular</term><term>Wolff-Parkinson-White Syndrome</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Electrocoagulation</term><term>Humans</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The fulguration procedure was originally introduced for the treatment of supraventricular arrhythmias by a pervenous interruption of His bundle conduction. This procedure has been extended to the treatment of almost any cardiac arrhythmia resistant to antiarrhythmic drug therapy. Recent results suggest that ablation could be selectively applied to the site of abnormal conduction. Overall results obtained at the Jean Rostand Hospital are reported for a series of 104 patients ranging in age from 14 to 83 years with atrial, junctional and ventricular tachycardias. The follow-up extends up to 65 months. Clinical efficacy, defined as a control of the arrhythmias by Fulguration used alone or in association with drug therapy that was previously ineffective, lead to a success rate ranging from 80 to 85%. Mortality was less than 10% in the worst situation (chronic resistant ventricular tachycardia). Mortality was always related to inappropriate protocols. Therefore, fulguration, which was originally reserved to treat the most difficult cases, is now considered for non-life-threatening but incapacitating arrhythmias.Despite these results the technique is not simple. Fulguration should be performed by groups knowledgeable in electrophysiology and with expertise in high voltage electricity and biophysics.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Ivry</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Fontaine, Guy" sort="Fontaine, Guy" uniqKey="Fontaine G" first="Guy" last="Fontaine">Guy Fontaine</name></region><name sortKey="Farenq, Gerard" sort="Farenq, Gerard" uniqKey="Farenq G" first="Gérard" last="Farenq">Gérard Farenq</name><name sortKey="Frank, Robert" sort="Frank, Robert" uniqKey="Frank R" first="Robert" last="Frank">Robert Frank</name><name sortKey="Grosgogeat, Yves" sort="Grosgogeat, Yves" uniqKey="Grosgogeat Y" first="Yves" last="Grosgogeat">Yves Grosgogeat</name><name sortKey="Rougier, Isabelle" sort="Rougier, Isabelle" uniqKey="Rougier I" first="Isabelle" last="Rougier">Isabelle Rougier</name><name sortKey="Tonet, Joelci" sort="Tonet, Joelci" uniqKey="Tonet J" first="Joelci" last="Tonet">Joelci Tonet</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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