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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

Authors
 Junbeom Park  ;  Jin Wi  ;  Boyoung Joung  ;  Moon Hyoung Lee  ;  Young-Hoon Kim  ;  Chun Hwang  ;  Hui-Nam Pak 
Citation
 INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol.167(3) : 981-986, 2013 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOLOGY 
ISSN
 0167-5273 
Issue Date
2013
MeSH
Adult ; Aged ; Aortic Valve/physiopathology ; Aortic Valve/surgery* ; Catheter Ablation/adverse effects ; Catheter Ablation/methods* ; Child ; Female ; Heart Septum/physiopathology ; Heart Septum/surgery* ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Assessment ; Tachycardia, Supraventricular/epidemiology* ; Tachycardia, Supraventricular/physiopathology ; Tachycardia, Supraventricular/surgery* ; Treatment Outcome
Keywords
Aortic cusp ; Atrial tachycardia ; Catheter ablation ; Supraventricular tachycardia
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0167527312002872
DOI
10.1016/j.ijcard.2012.03.082
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Jun Beom(박준범)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Wi, Jin(위진) ORCID logo https://orcid.org/0000-0003-0655-5130
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87875
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