Ablation of cardiac tissues by an electrode catheter technique for treatment of ectopic supraventricular tachycardia in adults.

Abstract

Five patients with chronic or recurrent ectopic supraventricular tachycardias unresponsive to drugs underwent programmed stimulation, endocardial mapping, and attempted catheter ablation of the arrhythmia focus. For attempted ablation, an intracardiac electrode catheter was positioned near the exit point of the tachycardia and served as the cathode while a chest wall patch served as the anode. In two patients with tachycardia originating near the coronary sinus, discharges of 200 or 400 J each were delivered to two electrodes at the earliest area of endocardial activation. These two patients with incessant tachycardia remain free of tachycardia for 17 and 11 months, respectively. In one patient with tachycardia originating from the right atrial appendage, both catheter and surgical ablation proved unsuccessful in that a new focus of atrial tachycardia supervened. This patient subsequently underwent successful catheter ablation of the atrioventricular junction. Two patients with junctional tachycardia underwent catheter ablation of the atrioventricular junction. Complete atrioventricular block followed atrioventricular junctional ablation and these patients required permanent cardiac pacing. The junctional tachycardia was replaced by sinus rhythm with episodes of unsustained atrial tachycardia. However, after 13 +/- 5 months follow-up, neither of the patients require antiarrhythmic drugs. Catheter ablation can be effective for atrial foci near the coronary sinus os, and can be performed with preservation of atrioventricular conduction. Arrhythmia ablation is possible in those with atrioventricular junctional tachycardia but requires the sacrifice of atrioventricular conduction. After ablation, other automatic atrial foci may become operative and complicate use of dual-chamber pacemakers.

Evolution of surgical methods for treating Wolff – Parkinson – White syndrome

“…Были описаны случаи разрыва коронарного синуса при трансвенозном воздействии электроразрядом в 100 Дж в этой области [13]. Поэтому большинство кардиохирургов пришли к выводу, что метод электродеструкции аритмогенного субстрата является высокотравматичным [13,32] и в настоящее время не применяется.…”

Closed Chest Radiofrequency Ablation of the Sinoatrial Node in Dogs

“…Sinus /unction was previously studied in terms of cycle lengtii, recovery time and atrial activation pattern by catheter mapping. SeveraJ discharges (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) were applied for variable periods of time (maximum 1 minutej. Sinus tachycardia and/or sinus arrest during ablation conjirmed correct catheter position.…”