Jun 1, 1991

A prospective evaluation of intracoronary ethanol ablation of the atrioventricular conduction system

Journal of the American College of Cardiology
G N KayV J Plumb


The clinical efficacy and complications associated with ablation of the atrioventricular (AV) conduction system by the selective infusion of ethanol into the AV node artery were prospectively assessed in 12 consecutive patients with medically refractory atrial arrhythmias. Six of the patients had previously failed to have permanent complete AV block created with direct current or radiofrequency catheter ablation. The AV node artery was cannulated with a 0.016 in. (0.041 cm) guide wire in all 12 patients. It was also possible to advance a 2.7F infusion catheter into the AV node artery in all patients. Transient AV block was induced by selective injections into the AV node artery of iced saline solution (8 patients) and of radiographic contrast agent (ioxaglate) (10 patients). The infusion of 2 ml of ethanol (96%) induced immediate complete AV block in all 10 patients who demonstrated AV block with ioxaglate. The escape rhythm exhibited a narrow QRS complex preceded by a His bundle deflection in nine patients and left bundle branch block in one patient. The immediate mean rate of the escape rhythm was 45.3 +/- 13.4 beats/min. In two patients who demonstrated reflux of contrast agent into the distal right coronary artery with sele...Continue Reading

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Mentioned in this Paper

Heart Block
Bundle-Branch Block
Cardiac Catheterization Procedures
Atrial Fibrillation
Atrioventricular Block
Sinus Node Artery
Structure of Atrioventricular Node
Infusions, Regional Arterial
Atrial Flutter

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