Treatment of supraventricular tachyarrhythmias using catheter ablation

pp 55-61

Abstract

Between august 1990 and august 1991, seven patients, four women and three men, with recurrent drug refractory tachyarrhythmias (including amiodarona), underwent catheter ablation procedures (electrofulguration). Five of them who had the Wolff-Parkinson-White syndrome, had reciprocating auriculoventricular tachycardias, one had nodal reentrant tachycardia and another one had auricular fibrillation. All but the one with auricular fibrillation underwent an electrophysiologic study in order to determine the tachyarrhythmias mechanism as well as the number of vias, location and characteristics. Five patients, those with WPW, undewent fulguration of the accesory pathway (three left laterals and two posteroseptals); in the patient with nodal reentrant, the AV node was fulgurated preserving the conduction, and as regards the one with auricular fibrillation, a complete AV blockade was provoked and a permanent pacemaker was placed. Initial success was of 100 %. During follow-up of 2-24 months, five patients remained asymptomatic without antiarrhythmic drugs, and two required drugs (which previously ineffective) thus remaining asymptomatic. The only complication was a patient who had pericardial effussion and required pericardiocentesis.