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Repolarization abnormalities after catheter ablation of differently located overt accessory pathways.
Rev Port Cardiol 2000; 19(5):553-65RP

Abstract

PURPOSE

Electrical repolarization abnormalities are usually seen after radiofrequency catheter ablation in overt accessory atrio-ventricular pathways. These abnormalities have been recognised as "cardiac memory". The aim of this study was to assess the relationships between electrical repolarization abnormalities and the location of the accessory atrioventricular pathway in the atrio-ventricular junction. We also assessed the relationship between electrical repolarization abnormalities and the degree of ventricular preexcitation.

MATERIAL AND METHODS

Our group consisted of 45 patients with overt and persistent preexcitation who were successfully submitted to radiofrequency catheter ablation. Mean age was 38.9 +/- 14.9 years (14 to 64), 28 of whom (62.2%) were male and 17 (37.8%) female. The location of accessory pathways the was left lateral in 14 patients, right posteroseptal in 14 patients, right mesoseptal in eight patients, right anteroseptal in four patients and other locations in the remaining four. Surface electrocardiograms were performed immediately following ablation, 24 hours later and three or more months after the procedure.

RESULTS

T wave abnormalities (flattened, inverted or peaked) were detected on the first day in 51% of patients, being more frequent after right accessory pathway ablation (86.9% versus 13.1% in left accessory pathways). These electrocardiographic changes were particularly frequent in patients with right mesoseptal (5/8, 62.5%) and posteroseptal (13/14, 93.3%) pathways, of which 62.5% and 71.5%, respectively, showed marked preexcitation before ablation. These findings were significantly different from those observed in patients with left lateral pathways--only 35.7% showed marked preexcitation and only two of fourteen patients (14.3%) presented T wave abnormalities after ablation. After the third month, most of the patients that had undergone successful ablation presented completed electrocardiographic normalization.

CONCLUSIONS

Patients undergoing radiofrequency catheter ablation for right accessory pathways show more frequently repolarization abnormalities than those submitted to ablation of the left lateral accessory pathways. The occurrence of these changes after preexcitation resolution may depend on the degree of previous preexcitation.

Authors+Show Affiliations

Serviço de Cardiologia, Hospitais da Universidade de Coimbra.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng por

PubMed ID

10916429

Citation

Coelho, L, et al. "Repolarization Abnormalities After Catheter Ablation of Differently Located Overt Accessory Pathways." Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, vol. 19, no. 5, 2000, pp. 553-65.
Coelho L, Elvas L, Ventura M, et al. Repolarization abnormalities after catheter ablation of differently located overt accessory pathways. Rev Port Cardiol. 2000;19(5):553-65.
Coelho, L., Elvas, L., Ventura, M., Cristóvão, J., Costa, M., Maldonado, M. J., ... Providência, L. A. (2000). Repolarization abnormalities after catheter ablation of differently located overt accessory pathways. Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology, 19(5), pp. 553-65.
Coelho L, et al. Repolarization Abnormalities After Catheter Ablation of Differently Located Overt Accessory Pathways. Rev Port Cardiol. 2000;19(5):553-65. PubMed PMID: 10916429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Repolarization abnormalities after catheter ablation of differently located overt accessory pathways. AU - Coelho,L, AU - Elvas,L, AU - Ventura,M, AU - Cristóvão,J, AU - Costa,M, AU - Maldonado,M J, AU - Guimarães,H, AU - Providência,L A, PY - 2000/8/1/pubmed PY - 2000/9/19/medline PY - 2000/8/1/entrez SP - 553 EP - 65 JF - Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology JO - Rev Port Cardiol VL - 19 IS - 5 N2 - PURPOSE: Electrical repolarization abnormalities are usually seen after radiofrequency catheter ablation in overt accessory atrio-ventricular pathways. These abnormalities have been recognised as "cardiac memory". The aim of this study was to assess the relationships between electrical repolarization abnormalities and the location of the accessory atrioventricular pathway in the atrio-ventricular junction. We also assessed the relationship between electrical repolarization abnormalities and the degree of ventricular preexcitation. MATERIAL AND METHODS: Our group consisted of 45 patients with overt and persistent preexcitation who were successfully submitted to radiofrequency catheter ablation. Mean age was 38.9 +/- 14.9 years (14 to 64), 28 of whom (62.2%) were male and 17 (37.8%) female. The location of accessory pathways the was left lateral in 14 patients, right posteroseptal in 14 patients, right mesoseptal in eight patients, right anteroseptal in four patients and other locations in the remaining four. Surface electrocardiograms were performed immediately following ablation, 24 hours later and three or more months after the procedure. RESULTS: T wave abnormalities (flattened, inverted or peaked) were detected on the first day in 51% of patients, being more frequent after right accessory pathway ablation (86.9% versus 13.1% in left accessory pathways). These electrocardiographic changes were particularly frequent in patients with right mesoseptal (5/8, 62.5%) and posteroseptal (13/14, 93.3%) pathways, of which 62.5% and 71.5%, respectively, showed marked preexcitation before ablation. These findings were significantly different from those observed in patients with left lateral pathways--only 35.7% showed marked preexcitation and only two of fourteen patients (14.3%) presented T wave abnormalities after ablation. After the third month, most of the patients that had undergone successful ablation presented completed electrocardiographic normalization. CONCLUSIONS: Patients undergoing radiofrequency catheter ablation for right accessory pathways show more frequently repolarization abnormalities than those submitted to ablation of the left lateral accessory pathways. The occurrence of these changes after preexcitation resolution may depend on the degree of previous preexcitation. SN - 0870-2551 UR - https://www.unboundmedicine.com/medline/citation/10916429/Repolarization_abnormalities_after_catheter_ablation_of_differently_located_overt_accessory_pathways_ DB - PRIME DP - Unbound Medicine ER -