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Title: Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle

Abstract

The purpose of this study was to describe a new technique for catheter ablation of the atrioventricular junction using radiofrequency energy delivered in the left ventricle. Catheter ablation of the atrioventricular (AV) junction using a catheter positioned across the tricuspid annulus was unsuccessful in eight patients with a mean {plus minus} SD age of 51 {plus minus} 19 years who had AV nodal reentry tachycardia (three patients), orthodromic tachycardia using a concealed midseptal accessory pathway, atrial tachycardia, atrial flutter (two patients), or atrial fibrillation. Before attempts at catheter ablation of the AV junction, each patient had been refractory to pharmacological therapy, and four had failed attempts at either catheter modification of the AV node using radiofrequency energy or surgical and catheter ablation of the accessory pathway. Conventional right-sided catheter ablation of the AV junction using radiofrequency energy in six patients and both radiofrequency energy and direct current shocks in two patients was ineffective. The mean amplitude of the His bundle potential recorded at the tricuspid annulus at the sites of unsuccessful AV junction ablation was 0.1 {plus minus} 0.08 mV, with a maximum His amplitude of 0.03-0.28 mV. A 7F deflectable-tip quadripolar electrode catheter with a 4-mm distal electrode wasmore » positioned against the upper left ventricular septum using a retrograde aortic approach from the femoral artery. Third-degree AV block was induced in each of the eight patients with 20-36 W applied for 15-30 seconds. The His bundle potential at the sites of successful AV junction ablation ranged from 0.06 to 0.99 mV, with a mean of 0.27 {plus minus} 0.32 mV. There was no rise in the creatine kinase-MB fraction and no complications occurred. An intrinsic escape rhythm of 30-60 beats/min was present in seven of the eight patients.« less

Authors:
; ; ; ; ;  [1]
  1. University of Michigan Medical Center, Ann Arbor (USA)
Publication Date:
OSTI Identifier:
5261426
Resource Type:
Journal Article
Journal Name:
Circulation; (United States)
Additional Journal Information:
Journal Volume: 84:2; Journal ID: ISSN 0009-7322
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; HEART; SENSITIVITY; RADIOWAVE RADIATION; BIOLOGICAL EFFECTS; ELECTROPHYSIOLOGY; MAN; RADIATION INJURIES; ANIMALS; BIOLOGICAL RADIATION EFFECTS; BODY; CARDIOVASCULAR SYSTEM; ELECTROMAGNETIC RADIATION; INJURIES; MAMMALS; ORGANS; PHYSIOLOGY; PRIMATES; RADIATION EFFECTS; RADIATIONS; VERTEBRATES; 560400* - Other Environmental Pollutant Effects

Citation Formats

Sousa, J, el-Atassi, R, Rosenheck, S, Calkins, H, Langberg, J, and Morady, F. Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle. United States: N. p., 1991. Web. doi:10.1161/01.CIR.84.2.567.
Sousa, J, el-Atassi, R, Rosenheck, S, Calkins, H, Langberg, J, & Morady, F. Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle. United States. https://doi.org/10.1161/01.CIR.84.2.567
Sousa, J, el-Atassi, R, Rosenheck, S, Calkins, H, Langberg, J, and Morady, F. 1991. "Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle". United States. https://doi.org/10.1161/01.CIR.84.2.567.
@article{osti_5261426,
title = {Radiofrequency catheter ablation of the atrioventricular junction from the left ventricle},
author = {Sousa, J and el-Atassi, R and Rosenheck, S and Calkins, H and Langberg, J and Morady, F},
abstractNote = {The purpose of this study was to describe a new technique for catheter ablation of the atrioventricular junction using radiofrequency energy delivered in the left ventricle. Catheter ablation of the atrioventricular (AV) junction using a catheter positioned across the tricuspid annulus was unsuccessful in eight patients with a mean {plus minus} SD age of 51 {plus minus} 19 years who had AV nodal reentry tachycardia (three patients), orthodromic tachycardia using a concealed midseptal accessory pathway, atrial tachycardia, atrial flutter (two patients), or atrial fibrillation. Before attempts at catheter ablation of the AV junction, each patient had been refractory to pharmacological therapy, and four had failed attempts at either catheter modification of the AV node using radiofrequency energy or surgical and catheter ablation of the accessory pathway. Conventional right-sided catheter ablation of the AV junction using radiofrequency energy in six patients and both radiofrequency energy and direct current shocks in two patients was ineffective. The mean amplitude of the His bundle potential recorded at the tricuspid annulus at the sites of unsuccessful AV junction ablation was 0.1 {plus minus} 0.08 mV, with a maximum His amplitude of 0.03-0.28 mV. A 7F deflectable-tip quadripolar electrode catheter with a 4-mm distal electrode was positioned against the upper left ventricular septum using a retrograde aortic approach from the femoral artery. Third-degree AV block was induced in each of the eight patients with 20-36 W applied for 15-30 seconds. The His bundle potential at the sites of successful AV junction ablation ranged from 0.06 to 0.99 mV, with a mean of 0.27 {plus minus} 0.32 mV. There was no rise in the creatine kinase-MB fraction and no complications occurred. An intrinsic escape rhythm of 30-60 beats/min was present in seven of the eight patients.},
doi = {10.1161/01.CIR.84.2.567},
url = {https://www.osti.gov/biblio/5261426}, journal = {Circulation; (United States)},
issn = {0009-7322},
number = ,
volume = 84:2,
place = {United States},
year = {Thu Aug 01 00:00:00 EDT 1991},
month = {Thu Aug 01 00:00:00 EDT 1991}
}