ISSN 1016-5169 | E-ISSN 1308-4488
Clinical Investigations Treatment of Cardiac Arryhthmias by Radiofrequency Catheter Ablation [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1996; 24(3): 136-143

Clinical Investigations Treatment of Cardiac Arryhthmias by Radiofrequency Catheter Ablation

Erdem DİKER1, U. Kemal TEZCAN1, Murat ÖZDEMİR1, Gülümser HEPER1, Şule KORKMAZ1, Sengül ÇEHRELİ1, Yalçın SÖZÜTEK1, Emine KÜTÜK1, Siber GÖKSEL1

We applied radiofrequency (RF) catheter ablation in 79 patients w ith various form s of tachycardia refractory to medical therapy in our clinic. Of these patients, 4 ı had atrioventricular (AV) reentrant taehyeardİa involving anA V accessory pathway, ı8 had AV nodal reentrant tachycardia (A VNRT), 8 had atrial fibrillation (AF), 3 had atrial tachycardia and 9 had ventricular tachycardia (VT). In patients with AF, AV node ablation was achieved by ıoo % success rate usirig right, and when neccessary left sided approaches. Atrioventricular conduction reappeared in 1 patient but was successfully reablated in the second session. Among ı8 cases with AVNRT, slow pathway ablation was tried in ı 7 and fa st pathway ablation in the remaining one. Two additicnal cases underwent fast pathway ablation after early recurrence of an unsuccessful slow pathway ablation. The procedure was successful in 16 patients (88 %) and complete AV block was intentionally created in one case (5 %) after unsuccessful attempts at node modification. Of the 4ı patients with accessory pathways, the pathway was located at the left free wall in 14, posteroseptal wall in 26 and right free wall in 1. The accessory pathway was concealed in 7 (50 %) of those w ith left free w all localization and in 2 (8 %) of those with posteroseptal localization. Thirteen (93%) of accessory pathways with left free wall localization and 20 (77%) of those with posteroseptal localization were successfully ablated. No recurrence was detected in patients with overt preexcitation. In only one case with a concelaled accessory pathway, attacks of tachycardia reappeared after RF ablation. Two of 3 cases with atrial tachycardia of right atrial origin (67%) were successfully ablated. The origin of VT was right ventricular outflow tract in 2 and the left ventricle in ı of 3 cases with idiopathic VT, and RF ablation was ~uccessful (100%) in all 3. All 6 patients with VT and structural heart disease, the tachycardia originated from the left ventricle. In 3 of these (50% ), the elinical VT disappeared after RF ablation. No recurrence wes noted in patients with atrial and ventricular tachycardia after an initial successful ablation. Thrombophlebitis in 2, arterial thrombosis in ı , complete AV block in 1 and inappropriate sinus tachycardia in 2 patients occurred as complications. The ablation procedure took a mean of 2.8 ± 1.4 hours in the who le population of patients. The maximal procedural length was 6 hours in two patients, one with an accessory pathway andanother one with VT. In conclusion, we successfully treated various supraventricular tachycardias and idiopathic ventricular tachycardias, but did not achieve the same high success rate in the treatment of ventricular tachycardias accompanying coronary artery disease with this technique. We believe the procedure is a safe one with quite a low complication rate.

How to cite this article
Erdem DİKER, U. Kemal TEZCAN, Murat ÖZDEMİR, Gülümser HEPER, Şule KORKMAZ, Sengül ÇEHRELİ, Yalçın SÖZÜTEK, Emine KÜTÜK, Siber GÖKSEL. Clinical Investigations Treatment of Cardiac Arryhthmias by Radiofrequency Catheter Ablation. Turk Kardiyol Dern Ars. 1996; 24(3): 136-143
Manuscript Language: Turkish

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