Oct 6, 1994

Radiofrequency catheter modification of atrioventricular conduction to control the ventricular rate during atrial fibrillation

The New England Journal of Medicine
B WilliamsonF Morady

Abstract

In some patients with atrial fibrillation, the ventricular rate may be difficult to control with medications. We evaluated a radiofrequency catheter technique to modify atrioventricular conduction in atrial fibrillation in order to control the ventricular rate without creating pathologic atrioventricular block. We studied 19 consecutive patients with atrial fibrillation and uncontrolled ventricular rates refractory to drug therapy. They had had atrial fibrillation for a mean (+/- SD) of 5.5 +/- 4.9 years, had had 4.9 +/- 0.9 unsuccessful drug trials, and were 62 +/- 15 years old. Before the procedure, the maximal ventricular rate during exercise was 180 +/- 39 beats per minute. A total of 11 +/- 5 radiofrequency-energy applications were delivered to the posterior septal or midseptal right atrium, near the ostium of the coronary sinus. Successful control of the ventricular rate without pathologic atrioventricular block was achieved in 14 of the 19 patients (74 percent). Persistent third-degree atrioventricular block requiring a permanent pacemaker occurred inadvertently in four patients (21 percent). Atrioventricular conduction was intentionally ablated in one patient. The 14 patients who had successful modification of conductio...Continue Reading

  • References28
  • Citations133

Mentioned in this Paper

Heart Block
Coronary Sinus Structure
Wernicke Aphasia
Recurrent Malignant Neoplasm
Right Atrial Structure
Atrial Fibrillation
Atrioventricular Block
Experimental drug
Entire Right Atrium
Ostium

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