Recurrence of Conduction Following Radiofrequency Catheter Ablation Procedures: Relationship to Ablation Target and Electrode Temperature.

Autor: Calkins, Hugh, Prystowsky, Eric, Berger, Ronald D., Saul, J. Philip, Klein, Lawrence S., Liem, L. Bing, Huang, S. K. Stephen, Gillette, Paul, Yong, Patrick, Carlson, Mark
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Zdroj: Journal of Cardiovascular Electrophysiology; Aug1996, Vol. 7 Issue 8, p704-712, 9p, 4 Charts, 1 Graph
Abstrakt: Introduction: More than 1 in 10 patients may develop recurrence of conduction after undergoing a successful radiofrequency catheter ablation procedure. The physiologic basis for recurrence following successful ablation procedures remains uncertain. The purpose of this study was to evaluate the role of electrode temperature as a predictor of recurrence following radiofrequency catheter ablation procedures. Methods and Results: The subjects of this study were 538 patients who underwent a successful attempt at radiofrequency catheter ablation of AV nodal reentrant tachycardia, an accessory pathway, and/or the AV junction. Patients were followed for a mean of 215 ± 138 days. Conduction recurred in 35 (6.5%) of the 538 patients. Recurrence of conduction occurred in 25 (9.3%) of 270 patients undergoing ablation of an accessory pathway, 7 (3.5%) of 201 patients undergoing ablation of AV nodal reentrant tachycardia, and in 3 <4.5%) of 67 patients undergoing ablation of the AV junction. The electrode temperature achieved at successful sites associated with recurrence was not different from the temperature achieved at successful sites without recurrence (61.1 ± 8.9 vs 61.6 ± 9.1; P = 0.8). The likelihood of developing a recurrence was higher following ablation of accessory pathways than following ablation of A V nodal reentrant tachycardia or the AV junction (P = 0.03). Patients experiencing a recurrence following ablation of an accessory pathway had longer procedure durations (P = 0.0001). Ablation of left free-wall pathways was associated with a lower incidence of recurrence as compared with all other locations (P = 0.008). Conclusion: The results of this study suggest that electrode temperature at the successful ablation site cannot be used to identify patients at highest risk of recurrence. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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