Catheter-Induced Ablation of the Atrioventricular Junction to Control Refractory Supraventricular Arrhythmias

Scheinman, Melvin M.; Morady, Fred; Hess, David; González, Rolando

doi:10.1001/jama.1982.03330070039027

Cited by 660 publications

(53 citation statements)

References 6 publications

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“…In 1982, the first catheter ablation (CA) aimed at achieving rate control by ablation of the atrioventricular junction [5, 6]. The first successful cut and sew surgical treatment (cut and sew Maze procedure) was performed in 1987 by Dr. Cox [7].…”

Section: Introductionmentioning

confidence: 99%

Hybrid ablation for atrial fibrillation: a systematic review

Vroomen

Pison

2016

J Interv Card Electrophysiol

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PurposeHybrid ablation for AF is performed in a growing number of centers. Due to absence of guidelines, operative approaches and perioperative care differ per center. In this review, an overview of findings from published studies on hybrid ablations is given, and related topics are discussed (e.g., one- and two-stage approaches, lesion sets, and patient management).MethodsA systematic literature search was performed in the PubMed and Embase databases. All identified articles were screened and checked for eligibility by the two authors.ResultsTwelve studies describing a total of 563 patients were selected. Due to substantial differences in approaches (one-stage, two-stage, sequential), surgical techniques (bilateral or monolateral thoracoscopy, subxiphoideal, transabdominal), energy sources (unipolar, bipolar), lesion sets (applying left or right atrial lesions), periprocedural care and endpoints (monitoring, definition of recurrence), and success rates (sinus rhythm after a mean of 26 months) are difficult to compare and varied from 27 % (without antiarrhythmic drugs, AADs) to 94 % (with AADs). For studies using bipolar devices, success rates with the use of antiarrhythmic drugs were at least 71 %. Major complications such as bleeding, sternotomy, and death occurred in 7 % of the total population (of which ten complications, 16 %, occurred in the concomitant cardiac surgery hybrid group).ConclusionThe field of AF ablation has dramatically changed over the past years, with one of the most recent developments the hybrid AF ablation. Lack of matching data hinders drawing conclusions and creating guidelines. Early results however are encouraging. More data are awaiting and needed.

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Section: Introductionmentioning

confidence: 99%

Hybrid ablation for atrial fibrillation: a systematic review

Vroomen

Pison

2016

J Interv Card Electrophysiol

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“…The outcome was optimal with no complications reported [44]. During the 1980s, AV node ablation using direct current became commonly used in developed countries for the management of patients with pharmacoresistant supraventricular arrhythmias [45].…”

Section: Atrioventricular (Av) Node Ablation and Permanent Pacemaker mentioning

confidence: 99%

Hybrid Therapy in the Management of Atrial Fibrillation

Stárek¹,

Lehar²,

Jež³

et al. 2014

CCR

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Atrial fibrillation is the most common sustained arrhythmia. Because of the sub-optimal outcomes and associated risks of medical therapy as well as the recent advances in non-pharmacologic strategies, a multitude of combined (hybrid) algorithms have been introduced that improve efficacy of standalone therapies while maintaining a high safety profile. Antiarrhythmic administration enhances success rate of electrical cardioversion. Catheter ablation of antiarrhythmic drug-induced typical atrial flutter may prevent recurrent atrial fibrillation. Through simple ablation in the right atrium, suppression of atrial fibrillation may be achieved in patients with previously ineffective antiarrhythmic therapy. Efficacy of complex catheter ablation in the left atrium is improved with antiarrhythmic drugs. Catheter ablation followed by permanent pacemaker implantation is an effective and safe treatment option for selected patients. Additional strategies include pacing therapies such as atrial pacing with permanent pacemakers, preventive pacing algorithms, and/or implantable dual-chamber defibrillators are available. Modern hybrid strategies combining both epicardial and endocardial approaches in order to create a complex set of radiofrequency lesions in the left atrium have demonstrated a high rate of success and warrant further research. Hybrid therapy for atrial fibrillation reviews history of development of non-pharmacological treatment strategies and outlines avenues of ongoing research in this field.

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“…First described by Scheinman and colleagues 30 in 1982, the ablation of the AV node– His bundle complex effectively controlled the irregular cardiac rhythm in AF and other supraventricular arrhythmias. Unfortunately, ablation of the AV node requires permanent pacemaker insertion.…”

Section: Medical Treatmentmentioning

confidence: 99%