Catheter ablation of the atrioventricular junction using radiofrequency energy and a bilateral cardiac approach.

Abstract

Radiofrequency current catheter ablation was used successfully to create complete atrioventricular (AV) block in 60 of 61 patients (98%) with drug refractory supraventricular tachyarrhythmias. The remaining patient developed Mobitz I AV block and is clinically improved (clinical efficacy 100%). In 54 patients (89%), complete AV block was achieved using a right-sided approach. Patients aged > 60 years needed significantly fewer right-sided radiofrequency applications to produce complete AV block (5.3 +/- 5.3 vs 11.1 +/- 10.0; p = 0.009). In 6 of 7 patients with unsuccessful right-sided ablation, a left ventricular approach was used. In each case, 1 to 4 additional radiofrequency applications produced complete AV block. Patients with unsuccessful right-sided ablation were generally younger than those with successful ablation (50 +/- 16 vs 64 +/- 11; p = 0.007). It is concluded that catheter ablation using radiofrequency current is an extremely effective means of producing complete AV block. Older patients appear to be more susceptible to right-sided radiofrequency approaches. Left ventricular ablation easily produces complete AV block in patients refractory to right-sided attempts.

• Authors: R G Trohman, T W Simmons, S L Moore, M S Firstenberg, D Williams, J D Maloney
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 70 Issue 18 Pg. 1438-43 (Dec 01 1992) ISSN: 0002-9149 [Print] United States
• PMID: 1442615 (Publication Type: Journal Article)

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Atrial Fibrillation (surgery)
• Atrioventricular Node (physiopathology, surgery)
• Bundle of His (physiopathology)
• Cardiac Tamponade (etiology)
• Cardiomyopathy, Hypertrophic (surgery)
• Catheter Ablation (adverse effects, instrumentation, methods)
• Electrocardiography
• Female
• Heart Block (physiopathology)
• Humans
• Male
• Middle Aged
• Pacemaker, Artificial
• Tachycardia, Supraventricular (surgery)
• Ventricular Fibrillation (etiology)