2013, Number 1
Transfer of patients with heart rate disorders for radiofrequency ablation and a five-year follow-up
Language: Spanish
References: 13
Page: 84-92
PDF size: 437.84 Kb.
ABSTRACT
Introduction: The possibility to locate structures involved in arrhythmias with the use of catheter electrodes gave an impetus to the development of techniques linked to the selective destruction of cardiac tissue. This is possible through radiofrequency catheter ablation. These procedures are the first choice treatment for most cardiac arrhythmias. The objective was to characterize clinically the pre and post therapeutic procedure for patients transferred to receive radiofrequency ablation.Method: A prospective and descriptive study in 26 patients with heart rhythm disorders who were referred for radiofrequency ablation and followed up for five years at the Cardiology Outpatient Department of the Dr. Gustavo Aldereguía Lima Hospital, in Cienfuegos. The variables studied were age, sex, type of clinical arrhythmia, arrhythmogenic substrate ablated, complications, initial success and recurrence of the treated arrhythmia.
Results: The mean age of patients was 40.9 ± 17.6 years, mostly women (57.7%). Younger patients (mean age 38.6 ± 19.7 years) were treated for atrioventricular nodal reentrant tachycardia and older patients (mean age 53.4 ± 23 years) underwent a non-selective ablation of the atrioventricular node. Half of the patients had orthodromic tachycardia; therefore, the most commonly treated arrhythmogenic substrate was an accessory pathway (65.4%). There were two major complications (7.7%), none of them directly related to the application of radiofrequency energy. In two patients (9.1%), the previously treated clinical arrhythmia recurred during the first year; both of them had right accessory pathways.
Conclusions: It was feasible to transfer patients for radiofrequency ablation because of agreements with two centers which conduct the procedure. Most of them had tachyarrhythmias involving accessory pathways. Only two major complications occurred; the initial success rate was adequate and the recurrence rate of the arrhythmia was small.
REFERENCES
Arbaiza JL, Dorantes M, Castro J, Zayas R, Quiñones MA, Bueno J, et al. Vías accesorias con arritmias de alta peligrosidad. Impacto de la ablación con radio-frecuencia. 2do Congreso Virtual de Cardiología; 1 Sept 3 Nov 2001. Argentina: CETIFAC [citado 8 Dic 2008]. Disponible en: www.fac.org.ar/scvc/llave/PDF/tl012e.PDF
European Heart Rhythm Association (EHRA); Euro-pean Cardiac Arrhythmia Scoiety (ECAS); American College of Cardiology (ACC); American Heart Association (AHA); Society of Thoracic Surgeons (STS), Calkins H, et al. HRS/EHRA/ECAS expert Consensus Statement of catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2007;4(6):816-61.
Friedman RA, Walsh EP, Silka MJ, Calkins H, Steven-son WG, Rhodes LA, et al. NASPE Expert Consensus Conference: Radiofrequency catheter ablation in children with and without congenital heart disease. Report of the Writing Committee. North American Society of Pacing and Electrophysiology. Pacing Clin Electrophysiol. 2002;25(6):1000-17.