[The predictors of success in the radiofrequency ablation of left accessory pathways using the single-catheter technic].

Abstract

INTRODUCTION AND OBJECTIVES:

To determine the predictors of successful radiofrequency current ablation of an accessory pathway using the single-catheter approach, we retrospectively analyzed 46 consecutive patients with left sided accessory atrioventricular pathways and manifest preexcitation.

METHODS:

Ablation using a single catheter advanced retrogradely towards the mitral valve was successful in 42 (91%). A radiofrequency pulse resulting in permanent accessory pathway block was defined as a successful pulse; a pulse that had no effect or caused only transient accessory pathway block was defined as an unsuccessful pulse.

RESULTS:

Successful radiofrequency pulses (n = 37) did not differ from those that failed (n = 56) in the local atrium-accessory pathway potential interval, in the accessory pathway-ventricle interval nor in the cumulative energy delivered. But in successful radiofrequency pulses, the amplitude ratio of local atrium and ventricular potentials tended to be larger (0.29 +/- 0.17 vs 0.23 +/- 0.17; p = 0.053) and presumed accessory pathway potential was more often recorded (36 [97%] vs 38 [68%]; p = 0.006). The time elapsed from the beginning of the current application and the accessory pathway block was shorter in successful pulses as compared to those pulses producing only transient block (3.3 +/- 2 s vs 6.9 +/- 4 s).

CONCLUSIONS:

The recording of a presumed accessory pathway potential, a large local A/V ratio and the occurrence of early conduction block in the accessory pathway were the best predictors of successful radiofrequency current application using the single-catheter approach.

• Authors: L Mont, M Schlüter, S Gürsoy, J Siebels, K H Kuck
• Journal: Revista espanola de cardiologia (Rev Esp Cardiol) Vol. 46 Issue 11 Pg. 745-51 (Nov 1993) ISSN: 0300-8932 [Print] Spain
• Vernacular Title: Predictores de éxito en la ablación de vías accesorias izquierdas mediante radiofrecuencia utilizando la técnica del catéter único.
• PMID: 8290777 (Publication Type: Comparative Study, English Abstract, Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Atrioventricular Node (abnormalities, surgery)
• Catheter Ablation (instrumentation, methods, statistics & numerical data)
• Chi-Square Distribution
• Child
• Electrocardiography (statistics & numerical data)
• Female
• Humans
• Male
• Middle Aged
• Pre-Excitation Syndromes (diagnosis, epidemiology, surgery)
• Prognosis
• Retrospective Studies