Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome
Identifieur interne : 000A40 ( Main/Corpus ); précédent : 000A39; suivant : 000A41Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome
Auteurs : Hugh Calkins ; Ching Mann ; Steven Kalbfleisch ; Jonathan J. Langberg ; Fred MoradySource :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1994-01.
English descriptors
Abstract
Site of Accessory Pathway Block. Introduction: Recent studies have demonstrated that the most common site of accessory pathway conduction block following the introduction of a premature atrial stimulus during atrial pacing is between the accessory pathway potential and the ventricular electrogram. consistent with block at the ventricular insertion of the accessory pathway. However, no prior study has evaluated the site of conduction block during radiofrequency catheter ablation procedures. Therefore, the objective of this study was to determine the site of conduction block after catheter ablation of accessory pathways by analyzing and comparing the local electrograms recorded before and after radiofrequency energy delivery at successful ablation sites. Methods and Results: The electrograms evaluated in this study were obtained from 85 consecutive patients who underwent successful radiofrequency catheter ablation of a manifest accessory pathway. The 50 left free‐wall accessory pathways were ablated using a ventricular approach and the 35 right free‐wall or posteroseptal accessory pathways were ablated using an atrial approach. The characteristics of local electrograms recorded immediately before and immediately after successful ablation of the accessory pathway were determined in each patient. The site of accessory pathway block was determined by comparing the amplitude, timing, and morphology of the local eleclrograms at successful sites of radiofrequency catheter ablation before and after delivery of radiofrequency energy. A putative accessory pathway potential was present at the successful target site in 74 of the 85 patients (87%). Conduction block occurred between the atrial electrogram and the accessory pathway potential in 66 patients (78%) and between the accessory pathway potential and the ventricular electrogram in eight patients (9%). The site of block could not be determined in 11 patients (13%) in whom an accessory pathway potential was absent. Conduction block occurred most frequently between the atrial electrogram and the accessory pathway potential regardless of accessory pathway location. No electrogram parameter or accessory pathway characteristic was predictive of the site of conduction block. Conclusion: The results of this study demonstrate that conduction block occurs most frequently between the local atrial electrogram and the accessory pathway potential during radiofrequency catheter ablation of accessory pathways. This is true regardless of whether the accessory pathway is ablated from the atrial or ventricular aspect of the mitral or tricuspid annulus.
Url:
DOI: 10.1111/j.1540-8167.1994.tb01111.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Calkins, Hugh" sort="Calkins, Hugh" uniqKey="Calkins H" first="Hugh" last="Calkins">Hugh Calkins</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Mann, Ching" sort="Mann, Ching" uniqKey="Mann C" first="Ching" last="Mann">Ching Mann</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Kalbfleisch, Steven" sort="Kalbfleisch, Steven" uniqKey="Kalbfleisch S" first="Steven" last="Kalbfleisch">Steven Kalbfleisch</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Langberg, Jonathan J" sort="Langberg, Jonathan J" uniqKey="Langberg J" first="Jonathan J." last="Langberg">Jonathan J. Langberg</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Morady, Fred" sort="Morady, Fred" uniqKey="Morady F" first="Fred" last="Morady">Fred Morady</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4</idno><date when="1994" year="1994">1994</date><idno type="doi">10.1111/j.1540-8167.1994.tb01111.x</idno><idno type="url">https://api.istex.fr/document/2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000A40</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Calkins, Hugh" sort="Calkins, Hugh" uniqKey="Calkins H" first="Hugh" last="Calkins">Hugh Calkins</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Mann, Ching" sort="Mann, Ching" uniqKey="Mann C" first="Ching" last="Mann">Ching Mann</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Kalbfleisch, Steven" sort="Kalbfleisch, Steven" uniqKey="Kalbfleisch S" first="Steven" last="Kalbfleisch">Steven Kalbfleisch</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Langberg, Jonathan J" sort="Langberg, Jonathan J" uniqKey="Langberg J" first="Jonathan J." last="Langberg">Jonathan J. Langberg</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author><author><name sortKey="Morady, Fred" sort="Morady, Fred" uniqKey="Morady F" first="Fred" last="Morady">Fred Morady</name><affiliation><mods:affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1994-01">1994-01</date><biblScope unit="volume">5</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="20">20</biblScope><biblScope unit="page" to="27">27</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4</idno><idno type="DOI">10.1111/j.1540-8167.1994.tb01111.x</idno><idno type="ArticleID">JCE20</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Wolff‐Parkinson‐White syndrome</term><term>catheter ablation</term><term>radiofrequency energy</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Site of Accessory Pathway Block. Introduction: Recent studies have demonstrated that the most common site of accessory pathway conduction block following the introduction of a premature atrial stimulus during atrial pacing is between the accessory pathway potential and the ventricular electrogram. consistent with block at the ventricular insertion of the accessory pathway. However, no prior study has evaluated the site of conduction block during radiofrequency catheter ablation procedures. Therefore, the objective of this study was to determine the site of conduction block after catheter ablation of accessory pathways by analyzing and comparing the local electrograms recorded before and after radiofrequency energy delivery at successful ablation sites. Methods and Results: The electrograms evaluated in this study were obtained from 85 consecutive patients who underwent successful radiofrequency catheter ablation of a manifest accessory pathway. The 50 left free‐wall accessory pathways were ablated using a ventricular approach and the 35 right free‐wall or posteroseptal accessory pathways were ablated using an atrial approach. The characteristics of local electrograms recorded immediately before and immediately after successful ablation of the accessory pathway were determined in each patient. The site of accessory pathway block was determined by comparing the amplitude, timing, and morphology of the local eleclrograms at successful sites of radiofrequency catheter ablation before and after delivery of radiofrequency energy. A putative accessory pathway potential was present at the successful target site in 74 of the 85 patients (87%). Conduction block occurred between the atrial electrogram and the accessory pathway potential in 66 patients (78%) and between the accessory pathway potential and the ventricular electrogram in eight patients (9%). The site of block could not be determined in 11 patients (13%) in whom an accessory pathway potential was absent. Conduction block occurred most frequently between the atrial electrogram and the accessory pathway potential regardless of accessory pathway location. No electrogram parameter or accessory pathway characteristic was predictive of the site of conduction block. Conclusion: The results of this study demonstrate that conduction block occurs most frequently between the local atrial electrogram and the accessory pathway potential during radiofrequency catheter ablation of accessory pathways. This is true regardless of whether the accessory pathway is ablated from the atrial or ventricular aspect of the mitral or tricuspid annulus.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>HUGH CALKINS M.D.</name><affiliations><json:string>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</json:string></affiliations></json:item><json:item><name>CHING MANN D.O.</name><affiliations><json:string>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</json:string></affiliations></json:item><json:item><name>STEVEN KALBFLEISCH M.D.</name><affiliations><json:string>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</json:string></affiliations></json:item><json:item><name>JONATHAN J. LANGBERG M.D.</name><affiliations><json:string>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</json:string></affiliations></json:item><json:item><name>FRED MORADY M.D.</name><affiliations><json:string>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Wolff‐Parkinson‐White syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>radiofrequency energy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>catheter ablation</value></json:item></subject><articleId><json:string>JCE20</json:string></articleId><language><json:string>eng</json:string></language><abstract>Site of Accessory Pathway Block. Introduction: Recent studies have demonstrated that the most common site of accessory pathway conduction block following the introduction of a premature atrial stimulus during atrial pacing is between the accessory pathway potential and the ventricular electrogram. consistent with block at the ventricular insertion of the accessory pathway. However, no prior study has evaluated the site of conduction block during radiofrequency catheter ablation procedures. Therefore, the objective of this study was to determine the site of conduction block after catheter ablation of accessory pathways by analyzing and comparing the local electrograms recorded before and after radiofrequency energy delivery at successful ablation sites. Methods and Results: The electrograms evaluated in this study were obtained from 85 consecutive patients who underwent successful radiofrequency catheter ablation of a manifest accessory pathway. The 50 left free‐wall accessory pathways were ablated using a ventricular approach and the 35 right free‐wall or posteroseptal accessory pathways were ablated using an atrial approach. The characteristics of local electrograms recorded immediately before and immediately after successful ablation of the accessory pathway were determined in each patient. The site of accessory pathway block was determined by comparing the amplitude, timing, and morphology of the local eleclrograms at successful sites of radiofrequency catheter ablation before and after delivery of radiofrequency energy. A putative accessory pathway potential was present at the successful target site in 74 of the 85 patients (87%). Conduction block occurred between the atrial electrogram and the accessory pathway potential in 66 patients (78%) and between the accessory pathway potential and the ventricular electrogram in eight patients (9%). The site of block could not be determined in 11 patients (13%) in whom an accessory pathway potential was absent. Conduction block occurred most frequently between the atrial electrogram and the accessory pathway potential regardless of accessory pathway location. No electrogram parameter or accessory pathway characteristic was predictive of the site of conduction block. Conclusion: The results of this study demonstrate that conduction block occurs most frequently between the local atrial electrogram and the accessory pathway potential during radiofrequency catheter ablation of accessory pathways. This is true regardless of whether the accessory pathway is ablated from the atrial or ventricular aspect of the mitral or tricuspid annulus.</abstract><qualityIndicators><score>8.165</score><pdfVersion>1.6</pdfVersion><pdfPageSize>580 x 787 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>2623</abstractCharCount><pdfWordCount>3665</pdfWordCount><pdfCharCount>24664</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>370</abstractWordCount></qualityIndicators><title>Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title><genre><json:string>article</json:string></genre><host><volume>5</volume><publisherId><json:string>JCE</json:string></publisherId><pages><total>8</total><last>27</last><first>20</first></pages><issn><json:string>1045-3873</json:string></issn><issue>1</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1540-8167</json:string></eissn><title>Journal of Cardiovascular Electrophysiology</title><doi><json:string>10.1111/(ISSN)1540-8167</json:string></doi></host><publicationDate>1994</publicationDate><copyrightDate>1994</copyrightDate><doi><json:string>10.1111/j.1540-8167.1994.tb01111.x</json:string></doi><id>2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><p>WILEY</p></availability><date>1994</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title><author><persName><forename type="first">HUGH</forename><surname>CALKINS</surname></persName><roleName type="degree">M.D.</roleName><note type="correspondence"><p>Correspondence: Hugh Calkins, M.D. Carnegie Room 530, Johns Hopkins Hospital. 601 North Wolfe Street, Baltimore, MD21210, Fax: 4l0‐614‐1345</p></note><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation></author><author><persName><forename type="first">CHING</forename><surname>MANN</surname></persName><roleName type="degree">D.O.</roleName><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation></author><author><persName><forename type="first">STEVEN</forename><surname>KALBFLEISCH</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation></author><author><persName><forename type="first">JONATHAN J.</forename><surname>LANGBERG</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation></author><author><persName><forename type="first">FRED</forename><surname>MORADY</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation></author></analytic><monogr><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="pISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><idno type="DOI">10.1111/(ISSN)1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1994-01"></date><biblScope unit="volume">5</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="20">20</biblScope><biblScope unit="page" to="27">27</biblScope></imprint></monogr><idno type="istex">2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4</idno><idno type="DOI">10.1111/j.1540-8167.1994.tb01111.x</idno><idno type="ArticleID">JCE20</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1994</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Site of Accessory Pathway Block. Introduction: Recent studies have demonstrated that the most common site of accessory pathway conduction block following the introduction of a premature atrial stimulus during atrial pacing is between the accessory pathway potential and the ventricular electrogram. consistent with block at the ventricular insertion of the accessory pathway. However, no prior study has evaluated the site of conduction block during radiofrequency catheter ablation procedures. Therefore, the objective of this study was to determine the site of conduction block after catheter ablation of accessory pathways by analyzing and comparing the local electrograms recorded before and after radiofrequency energy delivery at successful ablation sites. Methods and Results: The electrograms evaluated in this study were obtained from 85 consecutive patients who underwent successful radiofrequency catheter ablation of a manifest accessory pathway. The 50 left free‐wall accessory pathways were ablated using a ventricular approach and the 35 right free‐wall or posteroseptal accessory pathways were ablated using an atrial approach. The characteristics of local electrograms recorded immediately before and immediately after successful ablation of the accessory pathway were determined in each patient. The site of accessory pathway block was determined by comparing the amplitude, timing, and morphology of the local eleclrograms at successful sites of radiofrequency catheter ablation before and after delivery of radiofrequency energy. A putative accessory pathway potential was present at the successful target site in 74 of the 85 patients (87%). Conduction block occurred between the atrial electrogram and the accessory pathway potential in 66 patients (78%) and between the accessory pathway potential and the ventricular electrogram in eight patients (9%). The site of block could not be determined in 11 patients (13%) in whom an accessory pathway potential was absent. Conduction block occurred most frequently between the atrial electrogram and the accessory pathway potential regardless of accessory pathway location. No electrogram parameter or accessory pathway characteristic was predictive of the site of conduction block. Conclusion: The results of this study demonstrate that conduction block occurs most frequently between the local atrial electrogram and the accessory pathway potential during radiofrequency catheter ablation of accessory pathways. This is true regardless of whether the accessory pathway is ablated from the atrial or ventricular aspect of the mitral or tricuspid annulus.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Wolff‐Parkinson‐White syndrome</term></item><item><term>radiofrequency energy</term></item><item><term>catheter ablation</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1994-01">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8167</doi><issn type="print">1045-3873</issn><issn type="electronic">1540-8167</issn><idGroup><id type="product" value="JCE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY">Journal of Cardiovascular Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="01001"><doi origin="wiley">10.1111/jce.1994.5.issue-1</doi><numberingGroup><numbering type="journalVolume" number="5">5</numbering><numbering type="journalIssue" number="1">1</numbering></numberingGroup><coverDate startDate="1994-01">January 1994</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0002000" status="forIssue"><doi origin="wiley">10.1111/j.1540-8167.1994.tb01111.x</doi><idGroup><id type="unit" value="JCE20"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title><title type="tocHeading2"><!--WileyML 3Gv2 convertor changed from tocHeading1 to tocHeading2-->Clinical</title></titleGroup><eventGroup><event type="firstOnline" date="2007-04-29"></event><event type="publishedOnlineFinalForm" date="2007-04-29"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:HeaderRef result:HeaderRef" date="2010-03-10"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-29"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-23"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="20">20</numbering><numbering type="pageLast" number="27">27</numbering></numberingGroup><correspondenceTo>Hugh Calkins, M.D. Carnegie Room 530, Johns Hopkins Hospital. 601 North Wolfe Street, Baltimore, MD21210, Fax: 4l0‐614‐1345</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JCE.JCE20.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Manuscript received 30 April 1993; Accepted for publication 25 August 1993</unparsedEditorialHistory><countGroup><count type="referenceTotal" number="15"></count><count type="linksCrossRef" number="6"></count></countGroup><titleGroup><title type="main">Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1" corresponding="yes"><personName><givenNames>HUGH</givenNames><familyName>CALKINS</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>CHING</givenNames><familyName>MANN</familyName><degrees>D.O.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>STEVEN</givenNames><familyName>KALBFLEISCH</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>JONATHAN J.</givenNames><familyName>LANGBERG</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>FRED</givenNames><familyName>MORADY</familyName><degrees>M.D.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="US"><unparsedAffiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">Wolff‐Parkinson‐White syndrome</keyword><keyword xml:id="k2">radiofrequency energy</keyword><keyword xml:id="k3">catheter ablation</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Site of Accessory Pathway Block. <i>Introduction:</i> Recent studies have demonstrated that the most common site of accessory pathway conduction block following the introduction of a premature atrial stimulus during atrial pacing is between the accessory pathway potential and the ventricular electrogram. consistent with block at the ventricular insertion of the accessory pathway. However, no prior study has evaluated the site of conduction block during radiofrequency catheter ablation procedures. Therefore, the objective of this study was to determine the site of conduction block after catheter ablation of accessory pathways by analyzing and comparing the local electrograms recorded before and after radiofrequency energy delivery at successful ablation sites.</p><p> <i>Methods and Results:</i> The electrograms evaluated in this study were obtained from 85 consecutive patients who underwent successful radiofrequency catheter ablation of a manifest accessory pathway. The 50 left free‐wall accessory pathways were ablated using a ventricular approach and the 35 right free‐wall or posteroseptal accessory pathways were ablated using an atrial approach. The characteristics of local electrograms recorded immediately before and immediately after successful ablation of the accessory pathway were determined in each patient. The site of accessory pathway block was determined by comparing the amplitude, timing, and morphology of the local eleclrograms at successful sites of radiofrequency catheter ablation before and after delivery of radiofrequency energy. A putative accessory pathway potential was present at the successful target site in 74 of the 85 patients (87%). Conduction block occurred between the atrial electrogram and the accessory pathway potential in 66 patients (78%) and between the accessory pathway potential and the ventricular electrogram in eight patients (9%). The site of block could not be determined in 11 patients (13%) in whom an accessory pathway potential was absent. Conduction block occurred most frequently between the atrial electrogram and the accessory pathway potential regardless of accessory pathway location. No electrogram parameter or accessory pathway characteristic was predictive of the site of conduction block.</p><p> <i>Conclusion:</i> The results of this study demonstrate that conduction block occurs most frequently between the local atrial electrogram and the accessory pathway potential during radiofrequency catheter ablation of accessory pathways. This is true regardless of whether the accessory pathway is ablated from the atrial or ventricular aspect of the mitral or tricuspid annulus.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff‐Parkinson‐White Syndrome</title></titleInfo><name type="personal"><namePart type="given">HUGH</namePart><namePart type="family">CALKINS</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation><description>Correspondence: Hugh Calkins, M.D. Carnegie Room 530, Johns Hopkins Hospital. 601 North Wolfe Street, Baltimore, MD21210, Fax: 4l0‐614‐1345</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CHING</namePart><namePart type="family">MANN</namePart><namePart type="termsOfAddress">D.O.</namePart><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">STEVEN</namePart><namePart type="family">KALBFLEISCH</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JONATHAN J.</namePart><namePart type="family">LANGBERG</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">FRED</namePart><namePart type="family">MORADY</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Cardiology, Departmeni of Internal Medicine. University of Michigan Medical Center, Ann Arbor. Michigan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1994-01</dateIssued><edition>Manuscript received 30 April 1993; Accepted for publication 25 August 1993</edition><copyrightDate encoding="w3cdtf">1994</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">15</extent></physicalDescription><abstract lang="en">Site of Accessory Pathway Block. Introduction: Recent studies have demonstrated that the most common site of accessory pathway conduction block following the introduction of a premature atrial stimulus during atrial pacing is between the accessory pathway potential and the ventricular electrogram. consistent with block at the ventricular insertion of the accessory pathway. However, no prior study has evaluated the site of conduction block during radiofrequency catheter ablation procedures. Therefore, the objective of this study was to determine the site of conduction block after catheter ablation of accessory pathways by analyzing and comparing the local electrograms recorded before and after radiofrequency energy delivery at successful ablation sites. Methods and Results: The electrograms evaluated in this study were obtained from 85 consecutive patients who underwent successful radiofrequency catheter ablation of a manifest accessory pathway. The 50 left free‐wall accessory pathways were ablated using a ventricular approach and the 35 right free‐wall or posteroseptal accessory pathways were ablated using an atrial approach. The characteristics of local electrograms recorded immediately before and immediately after successful ablation of the accessory pathway were determined in each patient. The site of accessory pathway block was determined by comparing the amplitude, timing, and morphology of the local eleclrograms at successful sites of radiofrequency catheter ablation before and after delivery of radiofrequency energy. A putative accessory pathway potential was present at the successful target site in 74 of the 85 patients (87%). Conduction block occurred between the atrial electrogram and the accessory pathway potential in 66 patients (78%) and between the accessory pathway potential and the ventricular electrogram in eight patients (9%). The site of block could not be determined in 11 patients (13%) in whom an accessory pathway potential was absent. Conduction block occurred most frequently between the atrial electrogram and the accessory pathway potential regardless of accessory pathway location. No electrogram parameter or accessory pathway characteristic was predictive of the site of conduction block. Conclusion: The results of this study demonstrate that conduction block occurs most frequently between the local atrial electrogram and the accessory pathway potential during radiofrequency catheter ablation of accessory pathways. This is true regardless of whether the accessory pathway is ablated from the atrial or ventricular aspect of the mitral or tricuspid annulus.</abstract><subject lang="en"><genre>Keywords</genre><topic>Wolff‐Parkinson‐White syndrome</topic><topic>radiofrequency energy</topic><topic>catheter ablation</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Cardiovascular Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1045-3873</identifier><identifier type="eISSN">1540-8167</identifier><identifier type="DOI">10.1111/(ISSN)1540-8167</identifier><identifier type="PublisherID">JCE</identifier><part><date>1994</date><detail type="volume"><caption>vol.</caption><number>5</number></detail><detail type="issue"><caption>no.</caption><number>1</number></detail><extent unit="pages"><start>20</start><end>27</end><total>8</total></extent></part></relatedItem><identifier type="istex">2CADEE5DCFF10D8801FB771A3EF25D1C5EFBD2A4</identifier><identifier type="DOI">10.1111/j.1540-8167.1994.tb01111.x</identifier><identifier type="ArticleID">JCE20</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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