1. Gradual power titration using radiofrequency energy: a safe method for slow-pathway ablation in the setting of atrioventricular nodal re-entrant tachycardia
- Author
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Jean-Paul Albenque, Jean-Pierre Donzeau, Nicolas Combes, Serge Jandaud, Serge Boveda, Eloi Marijon, and Agustín Bortone
- Subjects
Adult ,Male ,Tachycardia ,medicine.medical_specialty ,Adolescent ,Heart block ,medicine.medical_treatment ,Catheter ablation ,Young Adult ,Risk Factors ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Tachycardia, Atrioventricular Nodal Reentry ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Middle Aged ,medicine.disease ,Ablation ,Power (physics) ,Heart Block ,Treatment Outcome ,Anesthesia ,Catheter Ablation ,Cardiology ,Female ,Re entrant ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Junctional rhythm ,Radiofrequency energy - Abstract
Aims In the setting of atrioventricular nodal re-entrant tachycardia (AVNRT), radiofrequency (RF) catheter ablation of the slow-pathway (SP) ensures excellent outcome. However, the risk of complete heart block (CHB) remains real (≈1%) and detrimental. This study reports on a gradual power titration approach using RF energy, which allows a significant decrease in CHB occurrence. Methods and results Slow-pathway ablation was performed in 468 patients (mean age 43.8 ± 17.2 years, 311 women). Initial settings were 5 W, 60°C, 120 s (temperature-controlled mode). The power was increased by steps of 5 W for every 5 s until slow-accelerated junctional rhythm was obtained, and then further increased to 10 W maximum above this value. The acute success rate, the mean RF pulses applied per patient, and the average power delivered per successful RF applications were 99%, 3.2 ± 1.1, and 31.7 ± 3.0 W, respectively. There were nine (1.9%) transient and reversible AV blocks, and one (0.2%) permanent CHB only necessitating pacemaker insertion. The recurrence rate was 3.6% and the follow-up period was 28.1 ± 14.1 months. Conclusion Atrioventricular nodal re-entrant tachycardia RF ablation using gradual power titration is an efficient technique, capable of improving safety since it can decrease CHB occurrence.
- Published
- 2008