2000, Number 1
<< Back Next >>
Arch Cardiol Mex 2000; 70 (1)
Radiofrequency catheter ablation of incessant atrial tachycardia
Velázquez RE, Morales HJA
Language: Spanish
References: 20
Page: 55-65
PDF size: 118.81 Kb.
ABSTRACT
Incessant atrial tachycardia is an infrequent arrhythmia. Especially difficult to treat medically. Radiofrequency catheter ablation has been used successfully to cure a variety of supraventricular tachycardias. The purpose of this work is to report our initial experience in the treatment of atrial tachycardia. Ten patients, mean age 28.7 ± 15 year with conventional drug-resistant symptomatic atrial tachycardia were treated with selective ablation of the focus using radiofrequency energy. It was found an abnormal automaticity in 10 tachycardias and in only one patient intra-atrial reentrant was supported. Radiofrequency energy was successful in 10 of 11 tachycardias with a mean of 9.3 ± 6.8 applications using the technique of local atrial electrogram activation time with a mean value of -54 ± 31 milliseconds at the successful ablation sites. No complications were observed and one patient had an early clinical recurrence. All patients with successful ablation are symptom-free, in sinus rhythm and without antiarrhythmic medications after 1 to 28 months of follow-up. Our initial experience support that radiofrequency catheter ablation is a safe and effective therapeutic option for incessant atrial tachycardia.
REFERENCES
Keane JF, Plauth WH, Nadas AS: Chronic ectopic tachycardia of infancy and childhood. Am Heart J 1972; 84:748-757.
Seals AA, Lawrie GM, Magro S, Lin HT, Pacifico A, Roberts R, et al: Surgical treatment of right atrial focal tachycardia in adults. J Am Coll Cardiol 1988; 11:1111-1117.
Mehta AV, Sánchez GR, Sacks EJ, Casta A, Dunn JM, Donner RM: Ectopic automatic atrial tachycardia in children: Clinical characteristics, management and follow-up. J Am Coll Cardiol 1988; 11:379-385.
Gillete PC, Garson A: Electrophysiologic and pharmacologic characteristics of automatic atrial tachycardia. Circulation 1977; 56:571-575.
Chiladakis JA, Vassilikos VP, Maounis TN, Cokkinos DV, Manolis AS: Successful radiofrequency catheter ablation of automatic atrial tachycardia with regression of the cardiomyopathy picture. PACE 1997; 20(Pt.I):953-959.
Shinbane JS, Wood MA, Jensen D, Ellenbogen KA, Fitzpatrick AP, Scheinman MM: Tachycardia-induced cardiomyopathy: A review of animal models and clinical studies. J Am Coll Cardiol 1997; 29:709-715.
Scheinman MM, Basu D, Hollenberg M: Electrophysio-logic studies in patients with persistent atrial tachycardia. Circulation 1974; 50:266-273.
Fisher JD, Lehmann MH: Marked intra-atrial conduction delay with split atrial electrograms: Substrate for reentrant supraventricular tachycardia. Am Heart J 1986; 111: 781-784.
Anderson KP, Stinson EB, Mason JW: Surgical exclusion of focal paroxysmal atrial tachycardia. Am J Cardiol 1982; 49:869-874.
Gillete PC, Wampler DG, Garson A Jr, Zimmer A, Oti D, Cooley D: Treatment of atrial automatic tachycardia by ablation procedures. J Am Coll Cardiol 1985; 6: 405-409.
Brockenbrough EC, Braunwald E: A new technique for left ventricular angiocardiography and transseptal left heart catheterization. Am J Cardiol 1966; 6:1062-1064.
Davis J, Scheinman MM, Ruder MA, Griffin JC, Herre JM, Finkebeiner WC, et al: Ablation of cardiac tissues by an electrode catheter technique for treatment of ectopic supraventricular tachycardias in adults. Circulation 1986; 74:1044-1053.
Tracy CM, Swartz JF, Fletcher RD, Hoops HG, Solomon AJ, Karasik PE, et al: Radiofrequency catheter ablation of ectopic atrial tachycardia using paced activation sequence mapping. J Am Coll Cardiol 1993; 21:910-917.
Fel K Gregory: Catheter ablation for the treatment of atrial tachycardia. Prog Cardiovasc Dis 1995; 37:205-224.
Walsh EP, Saul JP, Hulse JE, Rhodes LA, Hordof AJ, Mayer JE, et al: Transcatheter ablation of ectopic atrial tachycardia in young patients using radiofrequency current. Circulation 1992; 86:1138-1146.
Kay GN, Chong F, Epstein AE, Dailey SM, Plumb VJ: Radiofrequency ablation for treatment of primary atrial tachycardias. J Am Coll Cardiol 1993; 21:901-909.
Poty H, Saoudi N, Haissaguerre M, Daou A, Clémenty J, Letac B: Radiofrequency catheter ablation of atrial tachycardia. Am Heart J 1996; 131:481-489.
Weiss C, Willens S, Cappato R, Kuck KH, Meinertz T: High frequency current ablation of ectopic atrial tachycardia: Different mapping strategies for localization of right and left sided origin. Herz 1998; 23:269-279.
Merino JL, Arenal MA, Pérez-Villacastin J, Almendrai GJ, Peinado PR, Medina MO, et al: Ablación con catéter mediante radiofrecuencia de taquicardias auriculares. Rev Esp Cardiol 1997; 50:239-247.
Kottkamp H, Hindricks G, Breithard G, Borggrefe M: Three-dimensional electromagnetic catheter technology of ectopic atrial tachycardia. J Cardiovasc Electrophysiol 1997; 8:1332-1337.