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Prevalence, risk, and benefits of radiofrequency catheter ablation at the aortic cusp for the treatment of mid to anteroseptal supra-ventricular tachyarrhythmias

Title
Prevalence, risk, and benefits of radiofrequency catheter ablation at the aortic cusp for the treatment of mid to anteroseptal supra-ventricular tachyarrhythmias
Authors
Junbeom Park;Jin Wi;Hui-Nam Pak;Chun Hwang;Young-Hoon Kim;Moon Hyoung Lee;Boyoung Joung
Issue Date
2013
Journal Title
International Journal of Cardiology
ISSN
0167-5273
Citation
International Journal of Cardiology, Vol.167(3) : 981~986, 2013
Abstract
BACKGROUND: Some outflow tract ventricular tachycardias (VTs) are known to be successfully ablated from the aortic cusp (AC). However, radiofrequency catheter ablation (RFCA) at the AC for the treatment of supraventricular tachyarrhythmia (SVT) has limited experience. METHODS: We performed RFCA at the AC in 19 patients (male 64.7%, 46.9 ± 21.9 years old) with mid- to anteroseptal SVTs (12 atrial tachycardias [AT], 7 atrioventricular reciprocating tachycardia [AVRT]), and analyzed the prevalence, electrophysiologic findings, clinical outcome, and compilation risk. RESULTS: 1. Among 113 patients with AT, 13 patients had mid- to anteroseptal AT and 12 patients (8.8%, 53.4 ± 19.8 years old, 58.3% female) underwent successful ablation from the non-coronary cusp (NCC; n=10), right CC (RCC; n=1) or left CC (LCC; n=1) without complication (3.1 ± 2.3 times RF delivery, 6.15 ± 3.08 s for termination). During 19.7 ± 9.8 months of follow-up, AT recurred in a patient with multiple foci. 2. Among 580 patients with AVRT, 27 patients had a mid- to anteroseptal bypass tract (4.7%), and 7 of them (1.1%, 2 pre-excitation syndrome, 5 concealed bypass tract) were successfully ablated at the NCC (n=2) or RCC (n=5) (7.0 ± 7.1 times RF delivery, 9.1 ± 4.4s for termination). Among 5 patients with AVRT successfully ablated at the RCC, one patient developed complete heart block 48 h after procedure, and 2 patients recurred AVRT or delta-wave in ECG during 13.9 ± 11.7 month follow-up. CONCLUSION: Catheter ablation within the AC is an effective procedure to eliminate mid- to anteroseptal SVTs. However, RFCA on RCC requires a caution for heart block in our limited experience.
URI
http://www.sciencedirect.com/science/article/pii/S0167527312002872

http://ir.ymlib.yonsei.ac.kr/handle/22282913/87875
DOI
10.1016/j.ijcard.2012.03.082
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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