Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Feb 2006
Left atrionodal connections in typical and atypical atrioventricular nodal reentrant tachycardias: activation sequence in the coronary sinus and results of radiofrequency catheter ablation.
The presence of atrionodal connections and coronary sinus (CS) breakthrough in atrioventricular nodal reentrant tachycardia (AVNRT) has been suggested. However, the incidence, anatomic relationship with reentrant circuit, and results of catheter ablation are unknown. ⋯ Eccentric coronary sinus activation is observed in some rare cases of typical AVNRT, and in a majority of atypical AVNRT. Entrainment results suggest that the proximal coronary sinus may be part of the reentrant circuit. RF ablation of atypical AVNRT, if it fails from the standard right-side approach, can be targeted at the site of earliest retrograde atrial activation inside the CS.
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J. Cardiovasc. Electrophysiol. · Dec 2005
Mechanisms of phrenic nerve injury during radiofrequency ablation at the pulmonary vein orifice.
The phrenic nerve can be injured with radiofrequency energy delivery. Nevertheless, the mechanisms of injury are unknown. This study was undertaken to examine phrenic nerve tissue temperatures during ablation at the pulmonary vein (PV) orifice, assess the temperature dependence of injury, and to delineate the possible mechanisms of untoward nerve effects. ⋯ Phrenic nerve injury can be more common than anticipated with RF ablation at the RSPV orifice. Relatively low tissue temperatures can injure the nerve. Immediate nerve effects suggest a second mechanism of nerve dysfunction related to electrical current. Transient nerve effects occur prior to permanent damage, providing an opportunity to discontinue energy delivery before permanent injury.
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J. Cardiovasc. Electrophysiol. · Oct 2005
Determinants of recurrent ventricular arrhythmia or death in 300 consecutive patients with ischemic heart disease who experienced aborted sudden death: data from the Leiden out-of-hospital cardiac arrest study.
Evaluation of the relation between clinical characteristics and incidence of recurrent ventricular arrhythmias (VAs) or death during long-term follow-up in a cohort of 300 consecutive ischemic heart disease (IHD) patients who had survived an episode of sudden cardiac arrest (SCA). ⋯ In a cohort of 300 consecutive survivors of SCA the incidence of recurrent VA and death is dependent on patient age, history of heart failure, and use of amiodarone. In contrast, use of beta-blockers and aggressive coronary revascularization improve the outcome.
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J. Cardiovasc. Electrophysiol. · Sep 2005
Controlled Clinical TrialEfficacy and safety of cryoenergy in the ablation of atrioventricular reentrant tachycardia substrates in children and adolescents.
Cryoenergy has evolved as a safe and effective alternative for ablation of arrhythmia substrates in adult patients. Due to two specific features, cryomapping and cryoadhesion, this technique appears very attractive for pediatric patients minimizing complications and fluoroscopy time. The aim of the study was to investigate efficacy and safety of cryoenergy in the ablation of supraventricular tachycardia (SVT) substrates in pediatric patients. ⋯ Cryoablation of SVT substrates in pediatric patients was associated with a lower success rate compared to RF catheter ablation. Cryomapping decreased the number of permanent lesions but did not predict cryoablation outcome in all tachycardia substrates.