Electrophysiological features and radiofrequency catheter ablation of accessory pathways associated with atrioventricular discordance

2019 ◽  
Vol 31 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Daiji Takeuchi ◽  
Keiko Toyohara ◽  
Morio Shoda ◽  
Nobuhisa Hagiwara
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathways ◽  
Atrioventricular Discordance

Radiofrequency Catheter Ablation of Accessory Pathways During Entrainment of AV Reentrant Tachycardia

1994 ◽  
Vol 17 (4) ◽  
pp. 590-594 ◽  
Author(s):  
HUAGUI G. LI ◽  
GEORGE J. KLEIN ◽  
MARGO ZARDINI ◽  
RANJAN K. THAKUR ◽  
GARLOS A. MORILLO ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Reentrant Tachycardia ◽  
Accessory Pathways

scholarly journals Radiofrequency Catheter Ablation of Left Free Wall Accessory Pathways: Comparison Between Retrograde and Transeptal Approach

2012 ◽  
Vol 4 (2) ◽  
pp. 139-147
Author(s):  
S Hashem ◽  
M Hossain ◽  
MA Ali ◽  
AK Choudhury ◽  
AA Masum
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Similar Efficacy ◽  
Vascular Complication ◽  
Free Wall ◽  
Efficacy And Safety ◽  
Accessory Pathways ◽  
Intention To Treat ◽  
Primary Success ◽  
Ablation Success

Background : This study was conducted to compare the conventional retrograde arterial approach (RAA) with the transeptal approach (TSA) for radiofrequency catheter ablation (RFA) of left accessory pathways (AP). Materials and Methods: Sixty consecutive patients (44 male; mean age of 35.60 ± 11.63 years) with 60 left APs (39 overt and 21 concealed) underwent catheter ablation using the TS method (30 patients) and the RA method (30 patients) in an alternate fashion. The analysis was performed according to the intention-to-treat principle. Results : The transeptal puncture was successfully performed in 29 patients (96%). This access allowed primary success in the ablation in all the patients without any complication. When we compared this approach with the RAA there was no difference as regards the primary success (p = 0.103), fluoroscopy time (p = 0.565) and total time (p = 0.1917). Three patient in the RAA group presented a vascular complication. The TSA allowed shorter ablation times (p=0.006) and smaller number of radiofrequency applications (p = 0.042) as compared to the conventional RAA. The patients who had unsuccessful ablation in the first session in each approach underwent with the opposite technique (cross-over), with a final ablation success rate of 100%. Conclusion : The TS and RA approaches showed similar efficacy and safety for the ablation of left accessory pathways. The TSA allowed shorter ablation times and smaller number of radiofrequency applications. When the techniques were used in a complementary fashion, they increased the final efficacy of the ablation DOI: http://dx.doi.org/10.3329/cardio.v4i2.10458 Cardiovasc. j. 2012; 4(2): 139-147

Radiofrequency Catheter Ablation of Anteroseptal Accessory Pathways from Right Atrium

1999 ◽  
Vol 29 (10) ◽  
pp. 1089 ◽  
Author(s):  
Yun Shik Choi ◽  
Ji Dong Sung ◽  
Jong Min Song ◽  
In Ho Chae ◽  
Hyo Soo Kim ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Right Atrium ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathways

Concealed accessory pathways and related tachycardias

ESC CardioMed ◽  
2018 ◽  
pp. 2091-2092
Author(s):  
Carlo Pappone ◽  
Vincenzo Santinelli
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Node ◽  
Tricuspid Annulus ◽  
Atrioventricular Reentrant Tachycardia ◽  
Accessory Pathways ◽  
Purkinje System ◽  
Electrical Impulses ◽  
Supraventricular Tachycardias ◽  
Retrograde Conduction

Conduction from the atria to the ventricles normally occurs via the atrioventricular node–His–Purkinje system. Accessory pathways (APs) directly connect the atrium and ventricle and bypass the atrioventricular node, bridging the mitral or, less commonly, the tricuspid annulus. Concealed APs conduct electrical impulses retrogradely from the ventricles to the atria, but not antegradely from the atria to the ventricles. Approximately 40% of all APs are concealed, and orthodromic atrioventricular reentrant tachycardia due to concealed APs is present in up to 15% of patients with supraventricular tachycardias referred for catheter ablation. Most concealed APs are left-sided, exhibiting non-decremental retrograde conduction. Tachyarrhythmias due to concealed APs are managed similarly to those supraventricular tachycardias associated with manifest APs, and symptomatic tachyarrhythmias are successfully treated by radiofrequency catheter ablation in the majority of patients.

Comfort issues in patients undergoing radiofrequency catheter ablation

1995 ◽  
Vol 15 (1) ◽  
pp. 47-50 ◽  
Author(s):  
DM Guaglianone ◽  
A Tyndall
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Well Being ◽  
Patient Comfort ◽  
High Tech ◽  
Psychological Well Being ◽  
Accessory Pathways ◽  
Physical Comfort

The introduction of RFCA of accessory pathways offers an invasive yet safe cure for the potentially lethal arrhythmias associated with reentrant SVT. This lengthy procedure challenges nurses in providing patient comfort. It cannot be overemphasized how much these seemingly simple comfort measures can humanize an otherwise frighteningly "high-tech" atmosphere. Physical comfort as well as psychological well being will be enhanced with "high-touch" care. As RFCA becomes more common, further research must be directed toward maximizing comfort and minimizing complications.

Risk factors of recurrence and complication in radiofrequency catheter ablation of atrioventricular reentrant tachycardia in children and adolescents

2013 ◽  
Vol 23 (5) ◽  
pp. 682-691 ◽  
Author(s):  
Tien H. Chen ◽  
Ming-Lung Tsai ◽  
Po-Cheng Chang ◽  
Hung-Ta Wo ◽  
Chung-Chuan Chou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Catheter Ablation ◽  
Children And Adolescents ◽  
Radiofrequency Catheter Ablation ◽  
Congenital Heart ◽  
Accessory Pathway ◽  
Reentrant Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Accessory Pathways

AbstractBackgroundTo compare potential risk factors for complications and recurrence after radiofrequency catheter ablation in symptomatic atrioventricular reentrant tachycardia in children and adolescents.MethodsWe retrospectively reviewed the data of 213 consecutive patients with symptomatic atrioventricular reentrant tachycardia who underwent both electrophysiological study and radiofrequency catheter ablation, divided these patients into two groups, children (age <12 years) and adolescents (12 ≤ age < 18 years), and compared the location of the accessory pathway, success rate, recurrence rate, complications, presence of congenital heart disease, presence of intermittent ventricular pre-excitation, and presence of Wolff–Parkinson–White syndrome in the two groups.ResultsThe position of the accessory pathway was mostly right sided in children (61.3%) and left sided in adolescents (61.5%). Children had significantly more congenital heart disease than adolescents (6.4% versus 0.8%). Univariate analysis showed children or adolescents with right-sided accessory pathways to be 6.84 times and those with accessory pathways on both sides of the septum 25 times more likely to relapse than those with a single accessory pathway. Multivariate analysis indicated that children or adolescents with two accessory pathways were six times, and those with intermittent ventricular pre-excitation nine times more at risk of relapsing following radiofrequency ablation than those with single accessory pathways. All five complications occurred in children.ConclusionsThe findings suggest that the position and number of accessory pathways and presence of intermittent ventricular pre-excitation are related to risks of recurrence of atrioventricular reentrant tachycardia in children and adolescents.

Effect of radiofrequency catheter ablation of accessory pathways on autonomic tone in children

1999 ◽  
Vol 9 (4) ◽  
pp. 377-383 ◽  
Author(s):  
Ruchir Sehra ◽  
Joyce E. Hubbard ◽  
Susan P. Straka ◽  
Naomi S. Fineberg ◽  
Douglas P. Zipes ◽  
...  
Keyword(s):  
Heart Rate ◽  
Catheter Ablation ◽  
Supraventricular Tachycardia ◽  
Radiofrequency Catheter Ablation ◽  
Autonomic Function ◽  
Accessory Pathways ◽  
Non Invasive ◽  
Autonomic Changes ◽  
Before And After ◽  
Autonomic Blockade

AbstractBackgroundRadiofrequency catheter ablation is standard treatment for children with re-entrant supraventricular tachycardias. Autonomic changes have been noted after such ablation for atrioventricular nodal re-entry tachycardia, but not as well documented with atrioventricular re-entry over an accessory pathway.Methods and resultsIn 10 normal paediatric volunteers and 12 children referred for electrophysiologic testing and radiofrequency ablation of supraventricular tachycardia, non-invasive autonomic function tests and tilt-table testing were performed, and the variability in 24-h heart rate was analysed. Patients with supraventricular tachycardia underwent these tests both 24–72 h before and 24 h after ablation. Patients with tachycardia underwent additional autonomic testing to assess the sensitivity of baroreceptors and the intrinsic heart rate with autonomic blockade immediately before and after ablation. One non-invasive autonomic function test, namely handgrip, demonstrated significant differences (p < 0.05) in diastolic blood pressure before and after ablation, though these values did not differ from controls. Significant decreases were noted in two indexes of the variability of heart rate before and after ablation (p < 0.05). Certain tilt test variables also demonstrated significant differences between controls and those with tachycardia subsequent to ablation. Intracardiac testing demonstrated changes (p < 0.05) in sinus cycle lengths, effective refractory periods and/or blood pressures at baseline and during testing of the sensitivity of baroreceptors before and after ablation. These changes were consistent with increased sympathetic or decreased parasympathetic tone. With autonomic blockade, these differences were abolished.ConclusionsCatheter ablation of accessory pathways in children was associated with changes consistent with increased sympathetic or decreased parasympathetic tone. These autonomic changes persisted 24 h after the ablation procedure.

Slow and wide QRS complex tachycardia as a unique complication following radiofrequency catheter ablation of a left-sided accessory pathway in a child

2005 ◽  
Vol 15 (3) ◽  
pp. 315-318 ◽  
Author(s):  
Radu Vatasescu ◽  
Laszlo Kornyei ◽  
Tamas Szili-Torok
Keyword(s):  
Catheter Ablation ◽  
Slow Rate ◽  
Radiofrequency Catheter Ablation ◽  
Accessory Pathway ◽  
Qrs Complex ◽  
White Syndrome ◽  
Accessory Pathways ◽  
Radiofrequency Lesions ◽  
Transaortic Approach ◽  
Wolff Parkinson White Syndrome

Radiofrequency lesions can, theoretically, be the substrate for new persistent arrhythmias. As far as we know, this has never previously been encountered after transcatheter ablation of accessory pathways. A child with Wolff–Parkinson–White syndrome was referred for radiofrequency catheter ablation of a left-sided accessory pathway. After successful ablation of the accessory pathway using a retrograde transaortic approach, the child developed an incessant wide QRS complex tachycardia at slow rate that was resistant to pharmacologic interventions. The focus of the tachycardia was identical to the ventricular site of insertion of the eliminated accessory pathway.

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