Prospective evaluation of catheter ablation in patients with implantable cardioverter defibrillators and multiple inappropriate ICD therapies due to atrial fibrillation and type I atrial flutter.
The high incidence of inappropriate therapies due to drug refractory supraventricular tachycardia remains a major unsolved problem of the ICD. Most of the inappropriate therapies for supraventricular tachycardia are caused by AF and type I atrial flutter with rapid ventricular response. The purpose...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 24; no. 7; pp. 1061 - 1067 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Wiley-Blackwell
Jul2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106087656&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106087656 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Jul2001 vid: 24 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106087656 2009415354 10.1046/j.1460-9592.2001.01061.x NLM11475820 106087656 ppf: 1061 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Prospective evaluation of catheter ablation in patients with implantable cardioverter defibrillators and multiple inappropriate ICD therapies due to atrial fibrillation and type I atrial flutter. aug: au: Korte T Niehaus M Meyer O Tebbenjohanns J sug: subj: Atrial Fibrillation Therapy Atrial Flutter Therapy Catheter Ablation Defibrillators, Implantable Aged Middle Age Prospective Studies Human Aged: 65+ years Middle Aged: 45-64 years ab: The high incidence of inappropriate therapies due to drug refractory supraventricular tachycardia remains a major unsolved problem of the ICD. Most of the inappropriate therapies for supraventricular tachycardia are caused by AF and type I atrial flutter with rapid ventricular response. The purpose of this prospective study was to determine the usefulness of AVN modulation or ablation for rapid AF and ablation of the tricuspid annulus-inferior vena cava (TA-IVC) isthmus for type I atria! flutter in ICD patients with frequent inappropriate ICD interventions. Eighteen consecutive patients were enrolled in this study. Twelve patients received a mean of 34 ± 36 antitachycardia pacing (ATP) and 41 ± 32 shock therapies for rapid AF during 49 ± 39 months, and 6 patients a mean of 111 ± 200 ATP and 11 ± 8 shock therapies for type I atrial flutter during 52 ± 37 months preceding ablation procedure. Modification of the AVN was successful in 10 (83%) of 12 AF patients, in 2 (17%) patients ablation of the AVN was performed. A complete TA-IVC isthmus block was achieved in 5 (83%) of 6 atrial flutter patients. Three (25%) AF patients had 11 ± 24 recurrences of ATP and 0.4 ±1.1 shock therapies for rapid AF during 15 ± 7 months. None of the atrial flutter patients had recurrences of inappropriate therapies for type I atrial flutter during 14 ± 8 months, but two (33%) patients had inappropriate ICD therapies for type II atrial flutter or rapid AF. There was an overall mean incidence of 18 ±22 inappropriate ICD therapies per 6 months before and 4 ± 9 per 6 months after the ablation procedure (P < 0.05). In conclusion, radiofrequency catheter modification or ablation of the AVN for rapid AF and ablation for atrial flutter type I are demonstrated to be highly effective in the majority of ICD patients with drug refractory multiple inappropriate ICD therapies. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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