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Transcatheter radiofrequency ablation. Early experience with supraventricular tachyarrhythmias related to accessory atrioventricular and dual atrioventricular nodal pathways.
Med J Aust 1993; 159(2):97-102MJ

Abstract

OBJECTIVE

To describe our initial experience with transcatheter radiofrequency ablation, a useful new treatment for supraventricular tachyarrhythmias related to the presence of an accessory atrioventricular (AV) pathway or dual atrioventricular nodal pathways.

PATIENTS AND METHODS

One hundred and ten patients, including 77 with accessory pathways, 32 with dual atrioventricular (AV) nodal pathways and one with both, underwent electrophysiological studies and were treated with transcatheter radiofrequency ablation in a large metropolitan teaching hospital.

RESULTS

Ninety-five patients (86%) were without evidence of accessory pathway conduction or inducible supraventricular tachycardia and were free of symptoms after a mean follow-up of 13 months (range, 3.0-51 months). Sixty-six of 79 accessory pathways (83.5%) were ablated including 42 of 46 left-sided (91%), 14 of 21 posteroseptal (66%), six of seven anteroseptal (86%), three of four right-sided and one of one midseptal pathways. Thirty-one patients with AV nodal reentry were successfully treated by ablation of either the slow (12 patients) or fast (19 patients) conducting AV nodal pathway. There was a progressive improvement in the success rate of the first procedure from 17% to 64% with the use of large-tip catheters and from 64% to 91% when a purpose-built radiofrequency generator was employed. Complications occurred in nine patients: cardiac tamponade (two patients); mild mitral regurgitation (four); subclavian vein thrombosis (one); transient cerebral ischaemic attack (one); and non-thrombocytic purpuric rash (one). These occurred predominantly during the early experience and were without long-term sequelae. Late in our experience, one patient developed complete atrioventricular block requiring permanent pacemaker implantation.

CONCLUSIONS

In this institution, radiofrequency catheter ablation has been a safe and effective treatment strategy for patients with life-threatening or highly symptomatic supraventricular arrhythmias.

Authors+Show Affiliations

University of Western Australia, Crawley.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8336609

Citation

Weerasooriya, H R., et al. "Transcatheter Radiofrequency Ablation. Early Experience With Supraventricular Tachyarrhythmias Related to Accessory Atrioventricular and Dual Atrioventricular Nodal Pathways." The Medical Journal of Australia, vol. 159, no. 2, 1993, pp. 97-102.
Weerasooriya HR, Murdock CJ, Davis MJ. Transcatheter radiofrequency ablation. Early experience with supraventricular tachyarrhythmias related to accessory atrioventricular and dual atrioventricular nodal pathways. Med J Aust. 1993;159(2):97-102.
Weerasooriya, H. R., Murdock, C. J., & Davis, M. J. (1993). Transcatheter radiofrequency ablation. Early experience with supraventricular tachyarrhythmias related to accessory atrioventricular and dual atrioventricular nodal pathways. The Medical Journal of Australia, 159(2), pp. 97-102.
Weerasooriya HR, Murdock CJ, Davis MJ. Transcatheter Radiofrequency Ablation. Early Experience With Supraventricular Tachyarrhythmias Related to Accessory Atrioventricular and Dual Atrioventricular Nodal Pathways. Med J Aust. 1993 Jul 19;159(2):97-102. PubMed PMID: 8336609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transcatheter radiofrequency ablation. Early experience with supraventricular tachyarrhythmias related to accessory atrioventricular and dual atrioventricular nodal pathways. AU - Weerasooriya,H R, AU - Murdock,C J, AU - Davis,M J, PY - 1993/7/19/pubmed PY - 1993/7/19/medline PY - 1993/7/19/entrez SP - 97 EP - 102 JF - The Medical journal of Australia JO - Med. J. Aust. VL - 159 IS - 2 N2 - OBJECTIVE: To describe our initial experience with transcatheter radiofrequency ablation, a useful new treatment for supraventricular tachyarrhythmias related to the presence of an accessory atrioventricular (AV) pathway or dual atrioventricular nodal pathways. PATIENTS AND METHODS: One hundred and ten patients, including 77 with accessory pathways, 32 with dual atrioventricular (AV) nodal pathways and one with both, underwent electrophysiological studies and were treated with transcatheter radiofrequency ablation in a large metropolitan teaching hospital. RESULTS: Ninety-five patients (86%) were without evidence of accessory pathway conduction or inducible supraventricular tachycardia and were free of symptoms after a mean follow-up of 13 months (range, 3.0-51 months). Sixty-six of 79 accessory pathways (83.5%) were ablated including 42 of 46 left-sided (91%), 14 of 21 posteroseptal (66%), six of seven anteroseptal (86%), three of four right-sided and one of one midseptal pathways. Thirty-one patients with AV nodal reentry were successfully treated by ablation of either the slow (12 patients) or fast (19 patients) conducting AV nodal pathway. There was a progressive improvement in the success rate of the first procedure from 17% to 64% with the use of large-tip catheters and from 64% to 91% when a purpose-built radiofrequency generator was employed. Complications occurred in nine patients: cardiac tamponade (two patients); mild mitral regurgitation (four); subclavian vein thrombosis (one); transient cerebral ischaemic attack (one); and non-thrombocytic purpuric rash (one). These occurred predominantly during the early experience and were without long-term sequelae. Late in our experience, one patient developed complete atrioventricular block requiring permanent pacemaker implantation. CONCLUSIONS: In this institution, radiofrequency catheter ablation has been a safe and effective treatment strategy for patients with life-threatening or highly symptomatic supraventricular arrhythmias. SN - 0025-729X UR - https://www.unboundmedicine.com/medline/citation/8336609/Transcatheter_radiofrequency_ablation__Early_experience_with_supraventricular_tachyarrhythmias_related_to_accessory_atrioventricular_and_dual_atrioventricular_nodal_pathways_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0025-729X&date=1993&volume=159&issue=2&spage=97 DB - PRIME DP - Unbound Medicine ER -