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Titolo:
Abbreviated combined anatomical/electrophysiological approach for catheterablation of atrioventricular nodal reentrant tachycardia in children
Autore:
Bertram, H; Windhagen-Mahnert, B; Bokenkamp, R; Kriebel, T; Peuster, M; Hausdorf, G; Paul, T;
Indirizzi:
Childrens Hosp, Dept Pediat Cardiol & Pediat Intens Care Med, Hannover MedSch, Hannover, Germany Childrens Hosp Hannover Germany Med, Hannover MedSch, Hannover, Germany
Titolo Testata:
CARDIOLOGY IN THE YOUNG
fascicolo: 2, volume: 11, anno: 2001,
pagine: 182 - 187
SICI:
1047-9511(200103)11:2<182:ACAAFC>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
SLOW PATHWAY ABLATION; SUPRAVENTRICULAR TACHYCARDIA; RADIOFREQUENCY MODIFICATION; PEDIATRIC-PATIENTS; CONDUCTION; TEMPERATURE; JUNCTION; ENERGY; EFFICACY; ANTERIOR;
Keywords:
nodal reentrant tachycardia; interventional catheterisation; catheter ablation; children;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Bertram, H Hannover Med Sch, Dept Pediat Cardiol & Pediat, Carl Neuberg Str 1, D-30625 Hannover, Germany Hannover Med Sch Carl Neuberg Str 1 Hannover Germany D-30625 y
Citazione:
H. Bertram et al., "Abbreviated combined anatomical/electrophysiological approach for catheterablation of atrioventricular nodal reentrant tachycardia in children", CARD YOUNG, 11(2), 2001, pp. 182-187

Abstract

Atrioventricular nodal reentrant tachycardia was proven during electrophysiologic study in 41 children, aged from 3.7 to 16 years, who were referred for catheter ablation of symptomatic supraventricular tachycardia. Using anabbreviated combined anatomical and electrogram-guided approach for selective ablation of the slow pathway, a steerable ablation catheter was placed at the inferior region of the vestibule of the tricuspid valve close to theorifice of the coronary sinus, with the intention of recording a multicomponent local atrial electrogramm during sinus rhythm. If application of radiofrequency current of 500 kHz at 70 degreesC at this site did not result ina slowly accelerated junctional rhythm, at a rate of less than 120 beats per minute, the catheter was stepwise advanced up to a position midway towards the apex of the triangle of Koch for additional applications of energy. Ablation was achieved in 35 of the patients. In 6 patients, the slow pathway was modulated such that the tachycardia could no longer be induced. The number of applications of energy ranged from 1 to 19, with a median of 6 applications. The mean period of fluoroscopy was reduced to 15.6 (4.3 to 39.8)minutes, while the overall duration of the catheterization procedures ranged from 88 to 280 (mean 173.2) minutes. In none of the patients did we observe permanent high grade atrioventricular block. During follow-up over a mean of 4.1 years, two patients had recurrence of tachycardia, corresponding to a 95% rate of success in the midterm. We conclude that selective radiofrequency ablation of the slow pathway using the abbreviated anatomical and electrophysiological approach is a safe and curative therapeutic approach inchildren with atrioventricular nodal reentrant tachycardia. Periods required for fluoroscopy can be significantly reduced, and mid-term results are excellent.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 08:16:59