Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:
Identifieur interne : 000A82 ( Main/Corpus ); précédent : 000A81; suivant : 000A83Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:
Auteurs : Sanjay S. Deshpande ; Siobhan Bremner ; Jasbir S. Sra ; Anwer A. Dhala ; Zalmen Blanck ; Tanvir K. Bajwa ; Issam Al-Bitar ; Rami Gal ; Joseph S. Sarnoski ; Masood Akhtar ; Mohammad R. JazayeriSource :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1994-03.
English descriptors
Abstract
Transseptal versus Transaortic Ablation. Introduction: Transcatheter ablation of the left free‐wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. Methods and Results: One hundred consecutive patients with left free‐wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free‐wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty‐two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow‐up of 20 ± 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. Conclusion: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free‐wall APs by using cither a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.
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DOI: 10.1111/j.1540-8167.1994.tb01159.x
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Deshpande</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Bremner, Siobhan" sort="Bremner, Siobhan" uniqKey="Bremner S" first="Siobhan" last="Bremner">Siobhan Bremner</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Sra, Jasbir S" sort="Sra, Jasbir S" uniqKey="Sra J" first="Jasbir S." last="Sra">Jasbir S. Sra</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Dhala, Anwer A" sort="Dhala, Anwer A" uniqKey="Dhala A" first="Anwer A." last="Dhala">Anwer A. Dhala</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Blanck, Zalmen" sort="Blanck, Zalmen" uniqKey="Blanck Z" first="Zalmen" last="Blanck">Zalmen Blanck</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Bajwa, Tanvir K" sort="Bajwa, Tanvir K" uniqKey="Bajwa T" first="Tanvir K." last="Bajwa">Tanvir K. Bajwa</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Al Itar, Issam" sort="Al Itar, Issam" uniqKey="Al Itar I" first="Issam" last="Al-Bitar">Issam Al-Bitar</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Gal, Rami" sort="Gal, Rami" uniqKey="Gal R" first="Rami" last="Gal">Rami Gal</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Sarnoski, Joseph S" sort="Sarnoski, Joseph S" uniqKey="Sarnoski J" first="Joseph S." last="Sarnoski">Joseph S. Sarnoski</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Akhtar, Masood" sort="Akhtar, Masood" uniqKey="Akhtar M" first="Masood" last="Akhtar">Masood Akhtar</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Jazayeri, Mohammad R" sort="Jazayeri, Mohammad R" uniqKey="Jazayeri M" first="Mohammad R." last="Jazayeri">Mohammad R. Jazayeri</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:291DA170BFC1ABF1EEC46642C100B8B4FEDA0B25</idno><date when="1994" year="1994">1994</date><idno type="doi">10.1111/j.1540-8167.1994.tb01159.x</idno><idno type="url">https://api.istex.fr/document/291DA170BFC1ABF1EEC46642C100B8B4FEDA0B25/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000A82</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:</title><author><name sortKey="Deshpande, Sanjay S" sort="Deshpande, Sanjay S" uniqKey="Deshpande S" first="Sanjay S." last="Deshpande">Sanjay S. Deshpande</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Bremner, Siobhan" sort="Bremner, Siobhan" uniqKey="Bremner S" first="Siobhan" last="Bremner">Siobhan Bremner</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Sra, Jasbir S" sort="Sra, Jasbir S" uniqKey="Sra J" first="Jasbir S." last="Sra">Jasbir S. Sra</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Dhala, Anwer A" sort="Dhala, Anwer A" uniqKey="Dhala A" first="Anwer A." last="Dhala">Anwer A. Dhala</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Blanck, Zalmen" sort="Blanck, Zalmen" uniqKey="Blanck Z" first="Zalmen" last="Blanck">Zalmen Blanck</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Bajwa, Tanvir K" sort="Bajwa, Tanvir K" uniqKey="Bajwa T" first="Tanvir K." last="Bajwa">Tanvir K. Bajwa</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Al Itar, Issam" sort="Al Itar, Issam" uniqKey="Al Itar I" first="Issam" last="Al-Bitar">Issam Al-Bitar</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Gal, Rami" sort="Gal, Rami" uniqKey="Gal R" first="Rami" last="Gal">Rami Gal</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Sarnoski, Joseph S" sort="Sarnoski, Joseph S" uniqKey="Sarnoski J" first="Joseph S." last="Sarnoski">Joseph S. Sarnoski</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Akhtar, Masood" sort="Akhtar, Masood" uniqKey="Akhtar M" first="Masood" last="Akhtar">Masood Akhtar</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</mods:affiliation></affiliation></author><author><name sortKey="Jazayeri, Mohammad R" sort="Jazayeri, Mohammad R" uniqKey="Jazayeri M" first="Mohammad R." last="Jazayeri">Mohammad R. Jazayeri</name><affiliation><mods:affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</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="1994-03">1994-03</date><biblScope unit="volume">5</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="219">219</biblScope><biblScope unit="page" to="231">231</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">291DA170BFC1ABF1EEC46642C100B8B4FEDA0B25</idno><idno type="DOI">10.1111/j.1540-8167.1994.tb01159.x</idno><idno type="ArticleID">JCE219</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ablation</term><term>accessory pathway</term><term>atrial approach</term><term>left free wall</term><term>radiofrequency</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Transseptal versus Transaortic Ablation. Introduction: Transcatheter ablation of the left free‐wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. Methods and Results: One hundred consecutive patients with left free‐wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free‐wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty‐two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow‐up of 20 ± 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. Conclusion: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free‐wall APs by using cither a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>SANJAY S. DESHPANDE M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>SIOBHAN BREMNER R.N., M.P.H.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>JASBIR S. SRA M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>ANWER A. DHALA M.D</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>ZALMEN BLANCK M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>TANVIR K. BAJWA M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>ISSAM AL‐BITAR M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>RAMI GAL M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>JOSEPH S. SARNOSKI M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>MASOOD AKHTAR M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item><json:item><name>MOHAMMAD R. JAZAYERI M.D.</name><affiliations><json:string>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>left free wall</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>accessory pathway</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ablation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>radiofrequency</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>atrial approach</value></json:item></subject><articleId><json:string>JCE219</json:string></articleId><language><json:string>eng</json:string></language><abstract>Transseptal versus Transaortic Ablation. Introduction: Transcatheter ablation of the left free‐wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. Methods and Results: One hundred consecutive patients with left free‐wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free‐wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty‐two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow‐up of 20 ± 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. Conclusion: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free‐wall APs by using cither a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.</abstract><qualityIndicators><score>9.5</score><pdfVersion>1.6</pdfVersion><pdfPageSize>579 x 794 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1836</abstractCharCount><pdfWordCount>5696</pdfWordCount><pdfCharCount>37685</pdfCharCount><pdfPageCount>14</pdfPageCount><abstractWordCount>270</abstractWordCount></qualityIndicators><title>Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion 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Site:</title><title level="a" type="sub" xml:lang="en">Transseptal versus Transaortic Approach</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">Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:</title><title level="a" type="sub" xml:lang="en">Transseptal versus Transaortic Approach</title><author><persName><forename type="first">SANJAY S.</forename><surname>DESHPANDE</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">SIOBHAN</forename><surname>BREMNER</surname></persName><roleName type="degree">R.N., M.P.H.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">JASBIR S.</forename><surname>SRA</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">ANWER A.</forename><surname>DHALA</surname></persName><roleName type="degree">M.D</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">ZALMEN</forename><surname>BLANCK</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">TANVIR K.</forename><surname>BAJWA</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">ISSAM</forename><surname>AL‐BITAR</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">RAMI</forename><surname>GAL</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">JOSEPH S.</forename><surname>SARNOSKI</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">MASOOD</forename><surname>AKHTAR</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation></author><author><persName><forename type="first">MOHAMMAD R.</forename><surname>JAZAYERI</surname></persName><roleName type="degree">M.D.</roleName><note type="correspondence"><p>Correspondence: Mohammad R. Jazayeri, M.D., Sinai Samaritan Medical Center, Mount Sinai Campus. 950 N. 12th Street, Milwaukee, WI 53233. Fax: 414‐283‐6211.</p></note><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</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="1994-03"></date><biblScope unit="volume">5</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="219">219</biblScope><biblScope unit="page" to="231">231</biblScope></imprint></monogr><idno type="istex">291DA170BFC1ABF1EEC46642C100B8B4FEDA0B25</idno><idno type="DOI">10.1111/j.1540-8167.1994.tb01159.x</idno><idno type="ArticleID">JCE219</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1994</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Transseptal versus Transaortic Ablation. Introduction: Transcatheter ablation of the left free‐wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. Methods and Results: One hundred consecutive patients with left free‐wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free‐wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty‐two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow‐up of 20 ± 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. Conclusion: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free‐wall APs by using cither a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>left free wall</term></item><item><term>accessory pathway</term></item><item><term>ablation</term></item><item><term>radiofrequency</term></item><item><term>atrial approach</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1994-03">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/291DA170BFC1ABF1EEC46642C100B8B4FEDA0B25/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="03003"><doi origin="wiley">10.1111/jce.1994.5.issue-3</doi><numberingGroup><numbering type="journalVolume" number="5">5</numbering><numbering type="journalIssue" number="3">3</numbering></numberingGroup><coverDate startDate="1994-03">March 1994</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0021900" status="forIssue"><doi origin="wiley">10.1111/j.1540-8167.1994.tb01159.x</doi><idGroup><id type="unit" value="JCE219"></id></idGroup><countGroup><count type="pageTotal" number="13"></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="219">219</numbering><numbering type="pageLast" number="231">231</numbering></numberingGroup><correspondenceTo>Mohammad R. Jazayeri, M.D., Sinai Samaritan Medical Center, Mount Sinai Campus. 950 N. 12th Street, Milwaukee, WI 53233. Fax: 414‐283‐6211.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JCE.JCE219.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Manuscript received 8 March 1993; Accepted for publication 28 October 1993</unparsedEditorialHistory><countGroup><count type="referenceTotal" number="30"></count><count type="linksCrossRef" number="12"></count></countGroup><titleGroup><title type="main">Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:</title><title type="subtitle">Transseptal versus Transaortic Approach</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>SANJAY S.</givenNames><familyName>DESHPANDE</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>SIOBHAN</givenNames><familyName>BREMNER</familyName><degrees>R.N., M.P.H.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>JASBIR S.</givenNames><familyName>SRA</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>ANWER A.</givenNames><familyName>DHALA</familyName><degrees>M.D</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>ZALMEN</givenNames><familyName>BLANCK</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>TANVIR K.</givenNames><familyName>BAJWA</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1"><personName><givenNames>ISSAM</givenNames><familyName>AL‐BITAR</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>RAMI</givenNames><familyName>GAL</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a1"><personName><givenNames>JOSEPH S.</givenNames><familyName>SARNOSKI</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a1"><personName><givenNames>MASOOD</givenNames><familyName>AKHTAR</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr11" affiliationRef="#a1" corresponding="yes"><personName><givenNames>MOHAMMAD R.</givenNames><familyName>JAZAYERI</familyName><degrees>M.D.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="US"><unparsedAffiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">left free wall</keyword><keyword xml:id="k2">accessory pathway</keyword><keyword xml:id="k3">ablation</keyword><keyword xml:id="k4">radiofrequency</keyword><keyword xml:id="k5">atrial approach</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Transseptal versus Transaortic Ablation. <i>Introduction:</i> Transcatheter ablation of the left free‐wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated.</p><p> <i>Methods and Results:</i> One hundred consecutive patients with left free‐wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free‐wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty‐two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow‐up of 20 ± 8 months, none of the 100 patients had a recurrence of tachyarrhythmias.</p><p> <i>Conclusion:</i> These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free‐wall APs by using cither a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="n-fnt-1" numbered="no"><p>This study was presented in part at the Annual Scientific Sessions of the American Heart Association. Anaheim, CA. November 1994.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:</title><subTitle>Transseptal versus Transaortic Approach</subTitle></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Ablation of Left Free‐Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:</title></titleInfo><name type="personal"><namePart type="given">SANJAY S.</namePart><namePart type="family">DESHPANDE</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">SIOBHAN</namePart><namePart type="family">BREMNER</namePart><namePart type="termsOfAddress">R.N., M.P.H.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JASBIR S.</namePart><namePart type="family">SRA</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">ANWER A.</namePart><namePart type="family">DHALA</namePart><namePart type="termsOfAddress">M.D</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">ZALMEN</namePart><namePart type="family">BLANCK</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">TANVIR K.</namePart><namePart type="family">BAJWA</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">ISSAM</namePart><namePart type="family">AL‐BITAR</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">RAMI</namePart><namePart type="family">GAL</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JOSEPH S.</namePart><namePart type="family">SARNOSKI</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MASOOD</namePart><namePart type="family">AKHTAR</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MOHAMMAD R.</namePart><namePart type="family">JAZAYERI</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Electrophysiology Laboratory, University of Wisconsin Milwaukee Clinical Campus, Sinai Samaritan Medical Center‐Mount Sinai Campus, Milwaukee, Wisconsin</affiliation><description>Correspondence: Mohammad R. Jazayeri, M.D., Sinai Samaritan Medical Center, Mount Sinai Campus. 950 N. 12th Street, Milwaukee, WI 53233. Fax: 414‐283‐6211.</description><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">1994-03</dateIssued><edition>Manuscript received 8 March 1993; Accepted for publication 28 October 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">30</extent></physicalDescription><abstract lang="en">Transseptal versus Transaortic Ablation. Introduction: Transcatheter ablation of the left free‐wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. Methods and Results: One hundred consecutive patients with left free‐wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free‐wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty‐two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow‐up of 20 ± 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. Conclusion: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free‐wall APs by using cither a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.</abstract><subject lang="en"><genre>Keywords</genre><topic>left free wall</topic><topic>accessory pathway</topic><topic>ablation</topic><topic>radiofrequency</topic><topic>atrial approach</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>3</number></detail><extent unit="pages"><start>219</start><end>231</end><total>13</total></extent></part></relatedItem><identifier type="istex">291DA170BFC1ABF1EEC46642C100B8B4FEDA0B25</identifier><identifier type="DOI">10.1111/j.1540-8167.1994.tb01159.x</identifier><identifier type="ArticleID">JCE219</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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