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Article: Radiofrequency catheter ablation of inappropriate sinus tachycardia guided by activation mapping

TitleRadiofrequency catheter ablation of inappropriate sinus tachycardia guided by activation mapping
Authors
Issue Date2000
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jac
Citation
Journal Of The American College Of Cardiology, 2000, v. 35 n. 2, p. 451-457 How to Cite?
AbstractOBJECTIVE The purpose of this study was to evaluate the value of activation mapping for radiofrequency modification of the sinus node and the long-term success rate of the procedure in a series of patients with inappropriate sinus tachycardia. BACKGROUND: The results of radiofrequency ablation of inappropriate sinus tachycardia have been reported in only a small number of patients. METHODS: The subjects of this study were 29 consecutive drug-refractory patients who underwent catheter ablation of inappropriate sinus tachycardia. Target sites were selected by activation mapping during sinus tachycardia. RESULTS: The ablation procedure was successful acutely in reducing the baseline sinus rate to <90/min and the sinus rate during isoproterenol infusion by >20% in 22 of 29 patients (76%). In 13 of 22 patients (59%) with a successful acute outcome, successive applications of radiofrequency energy at the site of earliest endocardial activation resulted in a cranial-caudal migration of earliest endocardial activation from the high lateral right atrium, along with a step-wise reduction in heart rate. In the other nine patients (41%) with a successful acute outcome, the reduction in sinus rate occurred abruptly, unaccompanied by migration of the site of earliest activation. Symptoms due to inappropriate sinus tachycardia recurred at a mean of 4.4±; 3 months after the ablation procedure in 6 of 22 patients (27%). After additional procedures in three patients, symptoms of inappropriate sinus tachycardia ultimately were successfully eliminated over the long-term in 19 of 29 patients (66%). CONCLUSIONS: In conclusion, radiofrequency ablation is at best only modestly effective for managing patients with inappropriate sinus tachycardia. The two different responses of heart rate to radiofrequency ablation may reflect differences in the number and/or multicentricity of subsidiary sites of impulse generation within the sinus node and/or atrium in patients with inappropriate sinus tachycardia. (C) 2000 by the American College of Cardiology.
Persistent Identifierhttp://hdl.handle.net/10722/162423
ISSN
2015 Impact Factor: 17.759
2015 SCImago Journal Rankings: 10.097
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMan, KCen_US
dc.contributor.authorKnight, Ben_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorPelosi, Fen_US
dc.contributor.authorMichaud, GFen_US
dc.contributor.authorFlemming, Men_US
dc.contributor.authorStrickberger, SAen_US
dc.contributor.authorMorady, Fen_US
dc.date.accessioned2012-09-05T05:19:47Z-
dc.date.available2012-09-05T05:19:47Z-
dc.date.issued2000en_US
dc.identifier.citationJournal Of The American College Of Cardiology, 2000, v. 35 n. 2, p. 451-457en_US
dc.identifier.issn0735-1097en_US
dc.identifier.urihttp://hdl.handle.net/10722/162423-
dc.description.abstractOBJECTIVE The purpose of this study was to evaluate the value of activation mapping for radiofrequency modification of the sinus node and the long-term success rate of the procedure in a series of patients with inappropriate sinus tachycardia. BACKGROUND: The results of radiofrequency ablation of inappropriate sinus tachycardia have been reported in only a small number of patients. METHODS: The subjects of this study were 29 consecutive drug-refractory patients who underwent catheter ablation of inappropriate sinus tachycardia. Target sites were selected by activation mapping during sinus tachycardia. RESULTS: The ablation procedure was successful acutely in reducing the baseline sinus rate to <90/min and the sinus rate during isoproterenol infusion by >20% in 22 of 29 patients (76%). In 13 of 22 patients (59%) with a successful acute outcome, successive applications of radiofrequency energy at the site of earliest endocardial activation resulted in a cranial-caudal migration of earliest endocardial activation from the high lateral right atrium, along with a step-wise reduction in heart rate. In the other nine patients (41%) with a successful acute outcome, the reduction in sinus rate occurred abruptly, unaccompanied by migration of the site of earliest activation. Symptoms due to inappropriate sinus tachycardia recurred at a mean of 4.4±; 3 months after the ablation procedure in 6 of 22 patients (27%). After additional procedures in three patients, symptoms of inappropriate sinus tachycardia ultimately were successfully eliminated over the long-term in 19 of 29 patients (66%). CONCLUSIONS: In conclusion, radiofrequency ablation is at best only modestly effective for managing patients with inappropriate sinus tachycardia. The two different responses of heart rate to radiofrequency ablation may reflect differences in the number and/or multicentricity of subsidiary sites of impulse generation within the sinus node and/or atrium in patients with inappropriate sinus tachycardia. (C) 2000 by the American College of Cardiology.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jacen_US
dc.relation.ispartofJournal of the American College of Cardiologyen_US
dc.subject.meshAction Potentialsen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshBody Surface Potential Mapping - Methodsen_US
dc.subject.meshCatheter Ablationen_US
dc.subject.meshFemaleen_US
dc.subject.meshHeart Rateen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshRecurrenceen_US
dc.subject.meshReoperationen_US
dc.subject.meshTachycardia, Sinus - Physiopathology - Surgeryen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleRadiofrequency catheter ablation of inappropriate sinus tachycardia guided by activation mappingen_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.doi10.1016/S0735-1097(99)00546-Xen_US
dc.identifier.pmid10676693-
dc.identifier.scopuseid_2-s2.0-0034093211en_US
dc.identifier.hkuros62125-
dc.identifier.volume35en_US
dc.identifier.issue2en_US
dc.identifier.spage451en_US
dc.identifier.epage457en_US
dc.identifier.isiWOS:000085207100026-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridMan, KC=7101754043en_US
dc.identifier.scopusauthoridKnight, B=7201940628en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridPelosi, F=7004832991en_US
dc.identifier.scopusauthoridMichaud, GF=7006729860en_US
dc.identifier.scopusauthoridFlemming, M=7003616446en_US
dc.identifier.scopusauthoridStrickberger, SA=7005045293en_US
dc.identifier.scopusauthoridMorady, F=35431764400en_US

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