Fulguration of accessory pathways in any location: report of seventy cases.
Identifieur interne : 001857 ( PubMed/Corpus ); précédent : 001856; suivant : 001858Fulguration of accessory pathways in any location: report of seventy cases.
Auteurs : J F Warin ; M. HaissaguerreSource :
- Pacing and clinical electrophysiology : PACE [ 0147-8389 ] ; 1989.
English descriptors
- KwdEn :
- Action Potentials, Adult, Atrial Fibrillation (physiopathology), Atrial Fibrillation (surgery), Electrocoagulation (adverse effects), Electrocoagulation (methods), Female, Heart Block (etiology), Heart Conduction System (surgery), Humans, Male, Neural Pathways (surgery), Tachycardia (physiopathology), Tachycardia (surgery), Wolff-Parkinson-White Syndrome (physiopathology), Wolff-Parkinson-White Syndrome (surgery).
- MESH :
- adverse effects : Electrocoagulation.
- etiology : Heart Block.
- methods : Electrocoagulation.
- physiopathology : Atrial Fibrillation, Tachycardia, Wolff-Parkinson-White Syndrome.
- surgery : Atrial Fibrillation, Heart Conduction System, Neural Pathways, Tachycardia, Wolff-Parkinson-White Syndrome.
- Action Potentials, Adult, Female, Humans, Male.
Abstract
Ablation of accessory pathways (AP) in any location was performed in 70 consecutive patients using either a right or a left approach. Left free wall pathways were approached via a patent foramen ovale (eight patients) or by transseptal catheter (eight patients). The best ablation site was localized by recording a potential most likely due to Kent bundle activation (33/70 patients), the earliest site of retrograde atrial activation during orthodromic reciprocating tachycardia, earliest ventricular potentials recorded before or synchronous with the delta wave in standard ECG leads, disappearance of preexcitation due to pressure of the catheter on the AP (eight patients), good degree of pacemap concordance with ventricular preexcitation. Two 160 joules cathodal shocks in close succession were delivered and the sequence repeated depending on the results. Preexcitation disappeared in 63 patients and there was no recurrence of arrhythmia in 68 patients without any antiarrhythmic therapy over a follow-up ranging from 1 to 42 months. No serious side effects were observed except for two patients who developed permanent complete AV block. However, one of them occurred after an unsuccessful surgical attempt which had damaged the AV junction. Fulguration is effective for APs in diverse locations. These results indicate that appropriate treatment of patient with the Wolff-Parkinson-White syndrome should be reassessed. At present, the therapy of arrhythmias related to the Wolff-Parkinson-White syndrome is no longer a question of either antiarrhythmic drugs or surgery. Fulguration, in our experience, is effective for abolishing accessory pathways in any location.
PubMed: 2466255
Links to Exploration step
pubmed:2466255Le document en format XML
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<author><name sortKey="Warin, J F" sort="Warin, J F" uniqKey="Warin J" first="J F" last="Warin">J F Warin</name>
<affiliation><nlm:affiliation>Department of Cardiology, Saint-Andre Hospital, University of Bordeaux II, France.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Haissaguerre, M" sort="Haissaguerre, M" uniqKey="Haissaguerre M" first="M" last="Haissaguerre">M. Haissaguerre</name>
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<author><name sortKey="Warin, J F" sort="Warin, J F" uniqKey="Warin J" first="J F" last="Warin">J F Warin</name>
<affiliation><nlm:affiliation>Department of Cardiology, Saint-Andre Hospital, University of Bordeaux II, France.</nlm:affiliation>
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<author><name sortKey="Haissaguerre, M" sort="Haissaguerre, M" uniqKey="Haissaguerre M" first="M" last="Haissaguerre">M. Haissaguerre</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Action Potentials</term>
<term>Adult</term>
<term>Atrial Fibrillation (physiopathology)</term>
<term>Atrial Fibrillation (surgery)</term>
<term>Electrocoagulation (adverse effects)</term>
<term>Electrocoagulation (methods)</term>
<term>Female</term>
<term>Heart Block (etiology)</term>
<term>Heart Conduction System (surgery)</term>
<term>Humans</term>
<term>Male</term>
<term>Neural Pathways (surgery)</term>
<term>Tachycardia (physiopathology)</term>
<term>Tachycardia (surgery)</term>
<term>Wolff-Parkinson-White Syndrome (physiopathology)</term>
<term>Wolff-Parkinson-White Syndrome (surgery)</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electrocoagulation</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Heart Block</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electrocoagulation</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Atrial Fibrillation</term>
<term>Tachycardia</term>
<term>Wolff-Parkinson-White Syndrome</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Atrial Fibrillation</term>
<term>Heart Conduction System</term>
<term>Neural Pathways</term>
<term>Tachycardia</term>
<term>Wolff-Parkinson-White Syndrome</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Action Potentials</term>
<term>Adult</term>
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<front><div type="abstract" xml:lang="en">Ablation of accessory pathways (AP) in any location was performed in 70 consecutive patients using either a right or a left approach. Left free wall pathways were approached via a patent foramen ovale (eight patients) or by transseptal catheter (eight patients). The best ablation site was localized by recording a potential most likely due to Kent bundle activation (33/70 patients), the earliest site of retrograde atrial activation during orthodromic reciprocating tachycardia, earliest ventricular potentials recorded before or synchronous with the delta wave in standard ECG leads, disappearance of preexcitation due to pressure of the catheter on the AP (eight patients), good degree of pacemap concordance with ventricular preexcitation. Two 160 joules cathodal shocks in close succession were delivered and the sequence repeated depending on the results. Preexcitation disappeared in 63 patients and there was no recurrence of arrhythmia in 68 patients without any antiarrhythmic therapy over a follow-up ranging from 1 to 42 months. No serious side effects were observed except for two patients who developed permanent complete AV block. However, one of them occurred after an unsuccessful surgical attempt which had damaged the AV junction. Fulguration is effective for APs in diverse locations. These results indicate that appropriate treatment of patient with the Wolff-Parkinson-White syndrome should be reassessed. At present, the therapy of arrhythmias related to the Wolff-Parkinson-White syndrome is no longer a question of either antiarrhythmic drugs or surgery. Fulguration, in our experience, is effective for abolishing accessory pathways in any location.</div>
</front>
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<DateCreated><Year>1989</Year>
<Month>04</Month>
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<DateCompleted><Year>1989</Year>
<Month>04</Month>
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<DateRevised><Year>2004</Year>
<Month>11</Month>
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<Issue>1 Pt 2</Issue>
<PubDate><Year>1989</Year>
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<Title>Pacing and clinical electrophysiology : PACE</Title>
<ISOAbbreviation>Pacing Clin Electrophysiol</ISOAbbreviation>
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<ArticleTitle>Fulguration of accessory pathways in any location: report of seventy cases.</ArticleTitle>
<Pagination><MedlinePgn>215-8</MedlinePgn>
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<Abstract><AbstractText>Ablation of accessory pathways (AP) in any location was performed in 70 consecutive patients using either a right or a left approach. Left free wall pathways were approached via a patent foramen ovale (eight patients) or by transseptal catheter (eight patients). The best ablation site was localized by recording a potential most likely due to Kent bundle activation (33/70 patients), the earliest site of retrograde atrial activation during orthodromic reciprocating tachycardia, earliest ventricular potentials recorded before or synchronous with the delta wave in standard ECG leads, disappearance of preexcitation due to pressure of the catheter on the AP (eight patients), good degree of pacemap concordance with ventricular preexcitation. Two 160 joules cathodal shocks in close succession were delivered and the sequence repeated depending on the results. Preexcitation disappeared in 63 patients and there was no recurrence of arrhythmia in 68 patients without any antiarrhythmic therapy over a follow-up ranging from 1 to 42 months. No serious side effects were observed except for two patients who developed permanent complete AV block. However, one of them occurred after an unsuccessful surgical attempt which had damaged the AV junction. Fulguration is effective for APs in diverse locations. These results indicate that appropriate treatment of patient with the Wolff-Parkinson-White syndrome should be reassessed. At present, the therapy of arrhythmias related to the Wolff-Parkinson-White syndrome is no longer a question of either antiarrhythmic drugs or surgery. Fulguration, in our experience, is effective for abolishing accessory pathways in any location.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Warin</LastName>
<ForeName>J F</ForeName>
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<AffiliationInfo><Affiliation>Department of Cardiology, Saint-Andre Hospital, University of Bordeaux II, France.</Affiliation>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000200" MajorTopicYN="N">Action Potentials</DescriptorName>
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<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001281" MajorTopicYN="N">Atrial Fibrillation</DescriptorName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
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<MeshHeading><DescriptorName UI="D004564" MajorTopicYN="N">Electrocoagulation</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006327" MajorTopicYN="N">Heart Block</DescriptorName>
<QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName>
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<MeshHeading><DescriptorName UI="D006329" MajorTopicYN="N">Heart Conduction System</DescriptorName>
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<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
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<MeshHeading><DescriptorName UI="D009434" MajorTopicYN="N">Neural Pathways</DescriptorName>
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<MeshHeading><DescriptorName UI="D013610" MajorTopicYN="N">Tachycardia</DescriptorName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014927" MajorTopicYN="N">Wolff-Parkinson-White Syndrome</DescriptorName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
<QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName>
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