Efficacy and safety of an irrigated-tip catheter for the ablation of accessory pathways resistant to conventional radiofrequency ablation
Identifieur interne : 000156 ( PascalFrancis/Curation ); précédent : 000155; suivant : 000157Efficacy 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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<term>Cathétérisme</term>
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<term>Irrigation</term>
<term>Efficacité traitement</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>
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<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Eficacia tratamiento</s0>
<s5>07</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Toxicité</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Toxicity</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Toxicidad</s0>
<s5>08</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Irradiation haute fréquence</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Radiofrequency irradiation</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Irradiación alta frecuencia</s0>
<s5>09</s5>
</fC03>
<fC03 i1="10" i2="X" l="FRE"><s0>Voie conduction accessoire</s0>
<s4>INC</s4>
<s5>86</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Appareil circulatoire pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Cardiovascular disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Cardiopathie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Heart disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Cardiopatía</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Trouble rythme cardiaque</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Arrhythmia</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Arritmia</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Trouble excitabilité</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Excitability disorder</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Trastorno excitabilidad</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Trouble conduction</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Conduction disorder</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Trastorno conducción</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Préexcitation ventriculaire syndrome</s0>
<s5>42</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Preexcitation ventricular syndrome</s0>
<s5>42</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Preexcitación ventricular síndrome</s0>
<s5>42</s5>
</fC07>
<fC07 i1="07" i2="X" l="FRE"><s0>Traitement instrumental</s0>
<s5>43</s5>
</fC07>
<fC07 i1="07" i2="X" l="ENG"><s0>Instrumentation therapy</s0>
<s5>43</s5>
</fC07>
<fC07 i1="07" i2="X" l="SPA"><s0>Tratamiento instrumental</s0>
<s5>43</s5>
</fC07>
<fN21><s1>022</s1>
</fN21>
</pA>
</standard>
</inist>
</record>
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