Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

Telishevska, Marta; Faelchle, Johannes; Buiatti, Alessandra; Busch, Sonia; Reents, Tilko; Bourier, Félix; Semmler, Verena; Kaess, Bernhard M.; Horndasch, Michaela; Kornmayer, M.; Kottmaier, Marc; Deisenhofer, Isabel; Hessling, Gabriele

doi:10.1111/pace.13171

Cited by 7 publications

(6 citation statements)

References 24 publications

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“…The right free wall AP ablation procedures in our study were performed with very high PS and LTSR, which is comparable to recently published data [ 61 ]. In all right free wall AP procedures, we used real-time ICE imaging and a steerable sheath to position the ablation catheter beneath the tricuspid annulus—the so-called “loop” maneuver.…”

Section: Discussionsupporting

confidence: 89%

Zero-Fluoroscopy Catheter Ablation of Supraventricular Tachycardias in the Pediatric Population

Topalović,

Jan,

Kalinšek

et al. 2023

Children

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Catheter ablation (CA) of supraventricular tachycardias (SVTs) is conventionally performed with the aid of X-ray fluoroscopy. Usage of a three-dimensional (3D) electro-anatomical mapping (EAM) system and intracardiac echocardiography (ICE) enables zero-fluoroscopy ablation, eliminating the harmful effects of radiation. We retrospectively analyzed the feasibility, effectiveness and safety of zero-fluoroscopy radiofrequency and cryoablation of various types of SVTs in pediatric patients. Overall, in 171 consecutive patients (12.5 ± 3.9 years), 175 SVTs were diagnosed and 201 procedures were performed. The procedural success rate was 98% (193/197), or more precisely, 100% (86/86) for AVNRT, 95.8% (91/95) for AVRT, 94.1% (16/17) for AT and 100% (2/2) for AFL. No complications were recorded. Follow-up was complete in 100% (171/171) of patients. During the mean follow-up period of 488.4 ± 409.5 days, 98.2% of patients were arrhythmia-free with long-term success rates of 98.7% (78/79), 97.5% (78/80), 100% (13/13) and 100% (2/2) for AVNRT, AVRT, AT and AFL, respectively. Zero-fluoroscopy CA of various types of SVTs in the pediatric population is a feasible, effective and safe treatment option.

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Section: Discussionsupporting

confidence: 89%

Zero-Fluoroscopy Catheter Ablation of Supraventricular Tachycardias in the Pediatric Population

Topalović,

Jan,

Kalinšek

et al. 2023

Children

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“…American Heart Association and American College of Cardiology clinical practice guidelines currently recommend RFCA as first‐line therapy in AP patients with AVRT, preexcited AF, or both, citing several large case series that support this approach . These series report success rates of 93% to 95% and 3% risk of major complications in patients followed for 6 months to 8 years . Successful RFCA eliminates the need for continued antiarrhythmic drug therapy (unless other arrhythmia substrates are present), repeated hospitalizations for tachyarrhythmia breakthrough or CHF, and lifelong follow‐ups with a veterinary specialist.…”

Section: Discussionmentioning

confidence: 99%

Atrioventricular accessory pathways in 89 dogs: Clinical features and outcome after radiofrequency catheter ablation

Wright¹,

Connor

Irvin³

et al. 2018

Veterinary Internal Medicne

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BackgroundAtrioventricular accessory pathways (APs) in dogs have been reported rarely. Data regarding clinical presentation and long‐term outcome after radiofrequency catheter ablation (RFCA) are limited.Hypothesis/ObjectivesTo study clinical features, electrophysiologic characteristics, and outcome of RFCA in dogs with APs.AnimalsEighty‐nine dogs presented consecutively for RFCA of APs.MethodsCase series.ResultsLabrador retrievers (47.2% of dogs) and male dogs (67.4% of dogs) were most commonly affected. Labrador retrievers were more likely to be male than non‐Labrador breeds (P = .043). Clinical signs were nonspecific and most commonly included lethargy and gastrointestinal signs. Concealed APs were more prevalent in Labrador retrievers than other breeds (P = .001). Right‐sided APs (91.7%) predominated over left‐sided (8.3%). Tachycardia‐induced cardiomyopathy (TICM) occurred in 46.1% of dogs, with complete resolution or substantial improvement noted on one‐month postablation echocardiograms. Radiofrequency catheter ablation successfully eliminated AP conduction long term in 98.8% of dogs in which it was performed. Complications occurred in 5/89 dogs. Recurrence in 3 dogs was eliminated long term with a second procedure.Clinical Importance/ConclusionsAccessory pathways are challenging to recognize in dogs because of nonspecific clinical signs, frequency of concealed APs that show no evidence of their presence during sinus rhythm, and intermittent occurrence of tachyarrhythmias resulting from APs. Tachycardia‐induced cardiomyopathy commonly occurs with AP‐mediated tachycardias and should be considered in any dog presenting with a dilated cardiomyopathic phenotype because of its good long‐term prognosis with rhythm control. Radiofrequency catheter ablation is a highly effective method for eliminating AP conduction and providing long‐term resolution.

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“…Temperature control catheter (TCC) and irrigated-tip catheter (ITC) are two common options in AP-SVT radiofrequency ablation therapy. Compared with TCC, ITC perfused with cold saline can maintain a lower temperature at the electrode-tissue interface, increase thermal osmosis, and the transmission energy of ablation, thus generate a deeper and larger injury [7,8]. TCC with 4-mm tips have been adequate to ablate APs located near the endocardium.…”

Section: Introductionmentioning

confidence: 99%

The value of the accessory pathway potential in ablation within coronary sinus

Sun¹,

Xu²,

Tian³

et al. 2021

Preprint

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Background In accessory pathway-related supraventricular tachycardia ablation, coronary sinus (CS) ablation has received more and more attention, but there are no accurate criteria for catheter selection. Objectives We intended to develop a new method for the reasonable selection of electrode for coronary sinus ablation via assessing the relationship between the accessory pathway (AP) potential and time of successful ablation. Methods Among the patients who had detected the bypass potential during radiofre-quency ablation between 1/1/2015 and 12/31/2019, 30 patients underwent radiofrequency catheter ablation (RFCA) in CS. The relationship between AP potential and time of successful ablation was analyzed. Results In CS ablation, the median baseline amplitude of the AP potentials in patients with successful Temperature control catheter (TCC) ablation was higher than that in patients with Irrigated-tip catheter (ITC) following TCC ablation failure (p = 0.02). The optimal cutoff value of the amplitude of the AP potential to guide the selection of a catheter for ablation was 1.07 mV, and the sensitivity and specificity were 80% and 90%, respectively. Conclusions The AP potential is helpful for the electrode selection in CS ablation.

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Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

Cited by 7 publications

References 24 publications

Zero-Fluoroscopy Catheter Ablation of Supraventricular Tachycardias in the Pediatric Population

Zero-Fluoroscopy Catheter Ablation of Supraventricular Tachycardias in the Pediatric Population

Atrioventricular accessory pathways in 89 dogs: Clinical features and outcome after radiofrequency catheter ablation

The value of the accessory pathway potential in ablation within coronary sinus

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