A subvalvular catheter approach for radiofrequency ablation of right-sided accessory pathways

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
Marcus WieczorekReinhard Hoeltgen

Abstract

Conventional catheter ablation of right-sided accessory pathways (RAPs) can be challenging. To determine if a subvalvular catheter approach for RAPs targeting the ventricular insertion site, as on the left side, can improve catheter stability and tissue contact and thus increase acute and chronic ablation success rates. We retrospectively compared 22 patients (pts) with conventional catheter ablation of RAPs (group 1) with 9 consecutive pts (group 2) undergoing catheter ablation of a RAP using a subvalvular catheter approach targeting the ventricular site of AP. Ablation failed in 2/22 group 1 vs 0/9 group 2 pts (ns) and recurrences of AP conduction were registered in 4/19 group 1 vs 1/9 group 2 pts (ns) during follow-up. Significant shorter values were found in group 2 pts compared with group 1 for number of RF applications (3.6 ± 1.6 vs 8.2 ± 4.3), AP block time (6.2 ± 2.4 vs 9.2 ± 3.9 min), fluoroscopy time (17.2 ± 6.9 vs 25.6 ± 10.3 min), and procedure time (70.8 ± 23.9 vs 138 ± 44.4 min). There were no procedure related complications. Catheter ablation of RAPs using a subvalvular approach seems as effective and safe compared with conventional ablation but with reduced procedure time and radiation exposure and might be at l...Continue Reading

References

Dec 1, 1994·British Heart Journal·C TimmermansH J Wellens
Jun 1, 1994·Journal of Cardiovascular Electrophysiology·M HaïssaguerreJ Clémenty
Aug 1, 1993·Journal of the American College of Cardiology·M D LeshL A Epstein
Mar 1, 1996·Journal of the American College of Cardiology·F MoradyF Bogun
Nov 23, 2006·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Tom WongD Wyn Davies
Nov 26, 2009·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Hasim OlgunAlpay Celiker
Jul 22, 2018·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jun YangMinglong Chen

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