TY - JOUR
T1 - Prevalence, risk, and benefits of radiofrequency catheter ablation at the aortic cusp for the treatment of mid to anteroseptal supra-ventricular tachyarrhythmias
AU - Park, Junbeom
AU - Wi, Jin
AU - Joung, Boyoung
AU - Lee, Moon Hyoung
AU - Kim, Young Hoon
AU - Hwang, Chun
AU - Pak, Hui Nam
N1 - Funding Information:
This work was supported by a grant ( A085136 ) from the Korea Health 21 R&D Project of the Ministry of Health and Welfare and a grant ( 2010–0010537 ) from the Basic Science Research Program run by the National Research Foundation of Korea which is funded by the Ministry of Education, Science and Technology of the Republic of Korea .
PY - 2013/8/10
Y1 - 2013/8/10
N2 - Background: Some outflow tract ventricular tachycardias (VTs) are known to be successfully ablated from the aortic cusp (AC). However, radiofrequency catheter ablation (RFCA) at the AC for the treatment of supraventricular tachyarrhythmia (SVT) has limited experience. Methods: We performed RFCA at the AC in 19 patients (male 64.7%, 46.9 ± 21.9 years old) with mid- to anteroseptal SVTs (12 atrial tachycardias [AT], 7 atrioventricular reciprocating tachycardia [AVRT]), and analyzed the prevalence, electrophysiologic findings, clinical outcome, and compilation risk. Results: 1. Among 113 patients with AT, 13 patients had mid- to anteroseptal AT and 12 patients (8.8%, 53.4 ± 19.8 years old, 58.3% female) underwent successful ablation from the non-coronary cusp (NCC; n = 10), right CC (RCC; n = 1) or left CC (LCC; n = 1) without complication (3.1 ± 2.3 times RF delivery, 6.15 ± 3.08 s for termination). During 19.7 ± 9.8 months of follow-up, AT recurred in a patient with multiple foci. 2. Among 580 patients with AVRT, 27 patients had a mid- to anteroseptal bypass tract (4.7%), and 7 of them (1.1%, 2 pre-excitation syndrome, 5 concealed bypass tract) were successfully ablated at the NCC (n = 2) or RCC (n = 5) (7.0 ± 7.1 times RF delivery, 9.1 ± 4.4 s for termination). Among 5 patients with AVRT successfully ablated at the RCC, one patient developed complete heart block 48 h after procedure, and 2 patients recurred AVRT or delta-wave in ECG during 13.9 ± 11.7 month follow-up. Conclusion: Catheter ablation within the AC is an effective procedure to eliminate mid- to anteroseptal SVTs. However, RFCA on RCC requires a caution for heart block in our limited experience.
AB - Background: Some outflow tract ventricular tachycardias (VTs) are known to be successfully ablated from the aortic cusp (AC). However, radiofrequency catheter ablation (RFCA) at the AC for the treatment of supraventricular tachyarrhythmia (SVT) has limited experience. Methods: We performed RFCA at the AC in 19 patients (male 64.7%, 46.9 ± 21.9 years old) with mid- to anteroseptal SVTs (12 atrial tachycardias [AT], 7 atrioventricular reciprocating tachycardia [AVRT]), and analyzed the prevalence, electrophysiologic findings, clinical outcome, and compilation risk. Results: 1. Among 113 patients with AT, 13 patients had mid- to anteroseptal AT and 12 patients (8.8%, 53.4 ± 19.8 years old, 58.3% female) underwent successful ablation from the non-coronary cusp (NCC; n = 10), right CC (RCC; n = 1) or left CC (LCC; n = 1) without complication (3.1 ± 2.3 times RF delivery, 6.15 ± 3.08 s for termination). During 19.7 ± 9.8 months of follow-up, AT recurred in a patient with multiple foci. 2. Among 580 patients with AVRT, 27 patients had a mid- to anteroseptal bypass tract (4.7%), and 7 of them (1.1%, 2 pre-excitation syndrome, 5 concealed bypass tract) were successfully ablated at the NCC (n = 2) or RCC (n = 5) (7.0 ± 7.1 times RF delivery, 9.1 ± 4.4 s for termination). Among 5 patients with AVRT successfully ablated at the RCC, one patient developed complete heart block 48 h after procedure, and 2 patients recurred AVRT or delta-wave in ECG during 13.9 ± 11.7 month follow-up. Conclusion: Catheter ablation within the AC is an effective procedure to eliminate mid- to anteroseptal SVTs. However, RFCA on RCC requires a caution for heart block in our limited experience.
KW - Aortic cusp
KW - Atrial tachycardia
KW - Catheter ablation
KW - Supraventricular tachycardia
UR - http://www.scopus.com/inward/record.url?scp=84880918060&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2012.03.082
DO - 10.1016/j.ijcard.2012.03.082
M3 - Article
C2 - 22459399
AN - SCOPUS:84880918060
SN - 0167-5273
VL - 167
SP - 981
EP - 986
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -