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Article: Target temperatures of 48°C versus 60°C during slow pathway ablation: A randomized comparison

TitleTarget temperatures of 48°C versus 60°C during slow pathway ablation: A randomized comparison
Authors
Issue Date1999
PublisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
Citation
Journal Of Cardiovascular Electrophysiology, 1999, v. 10 n. 6, p. 799-803 How to Cite?
AbstractIntroduction: The relationship between temperature at the electrode- tissue interface and the loss of AV and ventriculoatrial (VA) conduction is not established, and the optimal target temperature for the slow pathway approach to radiofrequency ablation of AV nodal reentrant tachycardia (AVNRT) is unknown. Therefore, the purpose of this study was to compare target temperatures of 48°C and 60°C during the slow pathway approach to ablation of AVNRT. Methods and Results: The study included 138 patients undergoing ablation for AVNRT. Patients undergoing slow pathway ablation using closed- loop temperature monitoring were randomly assigned to a target temperature of either 48°C or 60°C. The primary success rates were 76% in the patients assigned to 48°C and 100% in the patients assigned to 60°C (P < 0.01). The ablation procedure duration (33 ± 31 min vs 26 ± 28 min; P = 0.2), fluoroscopic time (25 ± 15 min vs 24 ± 16 min; P = 0.5), and mean number of applications (9.3 ± 6.5 vs 7.8 ± 8.1; P = 0.3) were similar in patients assigned to 48°and 60°C, respectively. The mean temperature (46.1°± 24.8°C vs 48.7°± 3.2°C; P < 0.01), the temperature associated with junctional ectopy (48.1°± 2.0°C vs 53.5°± 3.5°C, P < 0.0001), and the frequency of VA block during junctional ectopy (24.6% vs 37.2%; P < 0.0001) were less in the patients assigned to 48°C compared to 60°C. The frequency of transient or permanent AV block was similar in each group (2.8% vs 3.6%; P = 0.2). In the 60°C group, only 12% of applications achieved an electrode temperature of 60°C. During follow-up of 9.9 ± 4.2 months, there was one recurrence of AVNRT in the 48°C group and none in the 60°C group. Conclusions: Compared to 48°C, a target temperature of 60°C during radiofrequency slow pathway ablation is associated with a higher primary success rate and a higher incidence of VA block during junctional ectopy induced by the radiofrequency energy. AV block is not more common with the higher target temperature, but only if VA conduction is aggressively monitored during applications of radiofrequency energy.
Persistent Identifierhttp://hdl.handle.net/10722/162339
ISSN
2015 Impact Factor: 3.097
2015 SCImago Journal Rankings: 1.863
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorStrickberger, SAen_US
dc.contributor.authorTokano, Ten_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorKim, MHen_US
dc.contributor.authorOral, Hen_US
dc.contributor.authorFlemming, Men_US
dc.contributor.authorPelosi, Fen_US
dc.contributor.authorMichaud, GFen_US
dc.contributor.authorKnight, BPen_US
dc.contributor.authorGoyal, Ren_US
dc.contributor.authorMorady, Fen_US
dc.date.accessioned2012-09-05T05:19:07Z-
dc.date.available2012-09-05T05:19:07Z-
dc.date.issued1999en_US
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 1999, v. 10 n. 6, p. 799-803en_US
dc.identifier.issn1045-3873en_US
dc.identifier.urihttp://hdl.handle.net/10722/162339-
dc.description.abstractIntroduction: The relationship between temperature at the electrode- tissue interface and the loss of AV and ventriculoatrial (VA) conduction is not established, and the optimal target temperature for the slow pathway approach to radiofrequency ablation of AV nodal reentrant tachycardia (AVNRT) is unknown. Therefore, the purpose of this study was to compare target temperatures of 48°C and 60°C during the slow pathway approach to ablation of AVNRT. Methods and Results: The study included 138 patients undergoing ablation for AVNRT. Patients undergoing slow pathway ablation using closed- loop temperature monitoring were randomly assigned to a target temperature of either 48°C or 60°C. The primary success rates were 76% in the patients assigned to 48°C and 100% in the patients assigned to 60°C (P < 0.01). The ablation procedure duration (33 ± 31 min vs 26 ± 28 min; P = 0.2), fluoroscopic time (25 ± 15 min vs 24 ± 16 min; P = 0.5), and mean number of applications (9.3 ± 6.5 vs 7.8 ± 8.1; P = 0.3) were similar in patients assigned to 48°and 60°C, respectively. The mean temperature (46.1°± 24.8°C vs 48.7°± 3.2°C; P < 0.01), the temperature associated with junctional ectopy (48.1°± 2.0°C vs 53.5°± 3.5°C, P < 0.0001), and the frequency of VA block during junctional ectopy (24.6% vs 37.2%; P < 0.0001) were less in the patients assigned to 48°C compared to 60°C. The frequency of transient or permanent AV block was similar in each group (2.8% vs 3.6%; P = 0.2). In the 60°C group, only 12% of applications achieved an electrode temperature of 60°C. During follow-up of 9.9 ± 4.2 months, there was one recurrence of AVNRT in the 48°C group and none in the 60°C group. Conclusions: Compared to 48°C, a target temperature of 60°C during radiofrequency slow pathway ablation is associated with a higher primary success rate and a higher incidence of VA block during junctional ectopy induced by the radiofrequency energy. AV block is not more common with the higher target temperature, but only if VA conduction is aggressively monitored during applications of radiofrequency energy.en_US
dc.languageengen_US
dc.publisherWiley-Blackwell Publishing, Inc. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873en_US
dc.relation.ispartofJournal of Cardiovascular Electrophysiologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshCatheter Ablation - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshTachycardia, Atrioventricular Nodal Reentry - Physiopathology - Surgeryen_US
dc.subject.meshTemperatureen_US
dc.titleTarget temperatures of 48°C versus 60°C during slow pathway ablation: A randomized comparisonen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1111/j.1540-8167.1999.tb00259.x-
dc.identifier.pmid10376916-
dc.identifier.scopuseid_2-s2.0-0033032770en_US
dc.identifier.hkuros41430-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0033032770&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume10en_US
dc.identifier.issue6en_US
dc.identifier.spage799en_US
dc.identifier.epage803en_US
dc.identifier.isiWOS:000080626000005-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridStrickberger, SA=7005045293en_US
dc.identifier.scopusauthoridTokano, T=7003372315en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridKim, MH=7406090815en_US
dc.identifier.scopusauthoridOral, H=7006855160en_US
dc.identifier.scopusauthoridFlemming, M=7003616446en_US
dc.identifier.scopusauthoridPelosi, F=7004832991en_US
dc.identifier.scopusauthoridMichaud, GF=7006729860en_US
dc.identifier.scopusauthoridKnight, BP=7201940628en_US
dc.identifier.scopusauthoridGoyal, R=7202793341en_US
dc.identifier.scopusauthoridMorady, F=35431764400en_US

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