scholarly journals Radiofrequency Catheter Ablation in Children with Supraventricular Tachycardias: Intermediate Term Follow up Results

2012 ◽  
Vol 6 ◽  
pp. CMC.S8578 ◽  
Author(s):  
Mm. Hafez ◽  
Mm. Abu-Elkheir ◽  
M. Shokier ◽  
Hf. Al-Marsafawy ◽  
Hm. Abo-Haded ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Electrophysiologic Study ◽  
Atrioventricular Reentrant Tachycardia ◽  
Pediatric Age Group ◽  
Line Of Therapy ◽  
Supraventricular Tachycardias

The Purpose of the Study Radiofrequency (RF) catheter ablation represents an important advance in the management of children with cardiac arrhythmias and has rapidly become the standard and effective line of therapy for supraventricular tachycardias (SVTs) in pediatrics. The purpose of this study was to evaluate the intermediate term follow up results of radiofrequency catheter ablation in treatment of SVT in pediatric age group. Methods A total of 60 pediatric patients (mean age = 12.4 ± 5.3 years, ranged from 3 years to 18 years; male: female = 37:23; mean body weight was 32.02 ± 12.3 kg, ranged from 14 kg to 60 kg) with clinically documented SVT underwent an electrophysiologic study (EPS) and RF catheter ablation at Children's Hospital Mansoura University, Mansoura, Egypt during the period from January 2008 to December 2009 and they were followed up until October 2011. Results The arrhythmias included atrioventricular reentrant tachycardia (AVRT; n = 45, 75%), atrioventricular nodal reentrant tachycardia (AVNRT; n = 6, 10%), and atrial tachycardia (AT; n = 9, 15%). The success rate of the RF catheter ablation was 93.3% for AVRT, 66.7% for AVNRT, and 77.8% for AT, respectively. Procedure-related complications were infrequent (7/60, 11.7%), (atrial flutter during RF catheter ablation (4/60, 6.6%); ventricular fibrillation during RF catheter ablation (1/60, 1.6%); transient complete heart block during RF catheter ablation (2/60, 3.3%)). The recurrence rate was 8.3% (5/60) during a follow-up period of 34 ± 12 months. Conclusion RF catheter ablation is an effective and safe method to manage children with SVT.

Ten years follow-up after radiofrequency catheter ablation for atrioventricular nodal reentrant tachycardia. Forever cured or a source for new arrhythmias?

Heart Rhythm ◽  
2005 ◽  
Vol 2 (5) ◽  
pp. S152
Author(s):  
Geert-Jan P. Kimman ◽  
Margot D. Bogaard ◽  
Pascal F.H.M. Van Dessel ◽  
Lucas V.A. Boersma ◽  
Eric F.D. Wever ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia

Abbreviated combined anatomical/electrophysiological approach for catheter ablation of atrioventricular nodal reentrant tachycardia in children

2001 ◽  
Vol 11 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Harald Bertram ◽  
Britta Windhagen-Mahnert ◽  
Regina Bökenkamp ◽  
Thomas Kriebel ◽  
Matthias Peuster ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Slow Pathway ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Electrophysiologic Study ◽  
Junctional Rhythm ◽  
Selective Ablation ◽  
Radiofrequency Current ◽  
Rate Of Success

Atrioventricular nodal reentrant tachycardia was proven during electrophysiologic study in 41 children, aged from 3.7 to 16 years, who were referred for catheter ablation of symptomatic supraventricular tachycardia. Using an abbreviated combined anatomical and electrogram-guided approach for selective ablation of the slow pathway, a steerable ablation catheter was placed at the inferior region of the vestibule of the tricuspid valve close to the orifice of the coronary sinus, with the intention of recording a multicomponent local atrial electrogramm during sinus rhythm. If application of radiofrequency current of 500 kHz at 70°C at this site did not result in a slowly accelerated junctional rhythm, at a rate of less than 120 beats per minute, the catheter was stepwise advanced up to a position midway towards the apex of the triangle of Koch for additional applications of energy. Ablation was achieved in 35 of the patients. In 6 patients, the slow pathway was modulated such that the tachycardia could no longer be induced. The number of applications of energy ranged from 1 to 19, with a median of 6 applications. The mean period of fluoroscopy was reduced to 15.6 (4.3 to 39.8) minutes, while the overall duration of the catheterization procedures ranged from 88 to 280 (mean 173.2) minutes. In none of the patients did we observe permanent high grade atrioventricular block. During follow-up over a mean of 4.1 years, two patients had recurrence of tachycardia, corresponding to a 95% rate of success in the midterm. We conclude that selective radiofrequency ablation of the slow pathway using the abbreviated anatomical and electrophysiological approach is a safe and curative therapeutic approach in children with atrioventricular nodal reentrant tachycardia. Periods required for fluoroscopy can be significantly reduced, and mid-term results are excellent.

scholarly journals Successful Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in a Patient with Dextrocardia and Situs Invertus

2011 ◽  
Vol 27 (Supplement) ◽  
pp. PE4_098
Author(s):  
Yoshiyasu Aizawa ◽  
Shunichiro Miyoshi ◽  
Takehiro Kimura ◽  
Nobuhiro Nishiyama ◽  
Kotaro Fukumoto ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia

scholarly journals Titration of Power Output During Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia

1993 ◽  
Vol 16 (3) ◽  
pp. 465-470 ◽  
Author(s):  
JONATHAN J. LANGBERG ◽  
MARK HARVEY ◽  
HUGH CALKINS ◽  
RAFEL EL-ATASSI ◽  
STEVEN J. KALBELEISGH ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Power Output ◽  
Radiofrequency Catheter Ablation ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia

Supraventricular Tachycardia

2020 ◽  
Author(s):  
Laurence M. Epstein ◽  
Saurabh Kumar
Keyword(s):  
Atrial Flutter ◽  
Supraventricular Tachycardia ◽  
Cardiac Tissue ◽  
Accessory Pathway ◽  
Maze Procedure ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Inappropriate Sinus Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Supraventricular Tachycardias

Supraventricular tachycardias (SVTs) comprise a group of usually benign arrhythmias that originate from cardiac tissue at or above the His bundle. SVTs include inappropriate sinus tachycardia, atrial tachycardias (ATs), atrial flutter (AFL), junctional tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT), and forms of accessory pathway–mediated reentrant tachycardias (atrioventricular reentrant tachycardia [AVRT]). Although mostly benign, symptoms can be debilitating, in the form of palpitations, shortness of breath, chest discomfort, dizziness, and/or syncope; rarely, SVTs can result in cardiomyopathy due to incessant arrhythmia. This review covers the epidemiology, diagnosis, management, and classification of SVTs.  This review contains 14 figures, 17 tables, and 61 references. Keywords: Supraventricular tachycardia, cardioversion, arrhythmia, atrial flutter, atrial fibrillation, Wolff-Parkinson-White syndrome, MAZE procedure, catheter ablation

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.

Introduction

ESC CardioMed ◽  
2018 ◽  
pp. 2049-2050
Author(s):  
Carina Blomström-Lundqvist
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Atrial Tachycardia ◽  
Atrioventricular Node ◽  
Supraventricular Arrhythmia ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Atrioventricular Reentrant Tachycardia ◽  
Dc Cardioversion ◽  
Premature Beats

Supraventricular arrhythmias encompass atrial premature beats, supraventricular tachycardias (SVTs), and atrial fibrillation. SVT is used to describe tachycardias in which the mechanism involves tissue from the His bundle or above, thus including atrial tachycardias, atrioventricular nodal reentrant tachycardia, and atrioventricular reentrant tachycardia due to accessory pathways. Atrial fibrillation is not included among the SVTs and is described elsewhere. The term tachycardia refers to atrial and/or ventricular rates greater than 100 beats per minute at rest. Atrial premature beats, the most common supraventricular arrhythmia, can be seen in Holter recordings in the majority of healthy individuals, and increase in frequency with age and presence of structural heart disease. Paroxysmal SVTs that can be terminated by vagal manoeuvres are usually reentrant tachycardias involving the atrioventricular node, such as atrioventricular nodal reentrant tachycardia or atrioventricular reentrant tachycardia. Symptoms may result in a poor quality of life. Rarely, patients with the Wolff–Parkinson–White syndrome develop atrial fibrillation that may degenerate into ventricular fibrillation in case the anterograde refractory period of the accessory pathway is very short and permanent forms of SVTs result in tachycardiomyopathy with left ventricular dysfunction. Paroxysmal SVT can be terminated by vagal manoeuvres, adenosine, overdrive pacing, and DC cardioversion. Atrial flutter, the most common atrial tachycardia, is a macro-reentrant atrial tachycardia that can be terminated by drugs, overdrive atrial pacing, and DC cardioversion. Most SVTs can be successfully treated by catheter ablation facilitated by modern electroanatomical mapping systems. Long-term antiarrhythmic drug therapy may be required for patients who are not suitable for or cured by catheter ablation.

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