Dec 1, 1989

Catheter ablation of the atrioventricular junction with radiofrequency energy

Circulation
J J LangbergM M Scheinman

Abstract

Catheter ablation of the atrioventricular junction using direct-current defibrillator discharges requires general anesthesia and may have serious side effects. Sixteen patients with drug-refractory supraventricular tachycardia underwent catheter ablation of the atrioventricular junction using radiofrequency energy. A standard 7F quadripolar electrode catheter was positioned to record the largest unipolar His potential (580 +/- 640 microV) from the distal electrode. An electrocoagulator (Microvasive Bicap 4005) supplied continuous, unmodulated energy at 550 kHz. One to 14 applications of radiofrequency current were delivered between the distal electrode and a large-diameter chest wall electrode. Transient, mild chest discomfort was reported by seven of 16 patients. None had significant arrhythmias or blood pressure changes during radiofrequency ablation. Complete atrioventricular block was produced in nine of 16 patients and high-grade second-degree atrioventricular block was produced in one patient with radiofrequency current. Attenuated His bundle electrograms could still be recorded in the remaining six patients, four of whom underwent successful atrioventricular junctional ablation using direct-current shock during the same ...Continue Reading

  • References8
  • Citations144
  • References8
  • Citations144

Mentioned in this Paper

Supraventricular Tachycardia
Heart Block
Entire Chest Wall
Creatine Kinase Measurement
Atrioventricular Block
Chest Discomfort
General Anesthesia [PE]
Cardiac Conduction System
Structure of Atrioventricular Node
Body Fluid Discharge

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