Management of Cardiac Arrhythmias With Radiofrequency Catheter Ablation

Abstract

Radiofrequency energy has emerged as the current energy source of first choice for ablation procedures. We review the development of radiofrequency energy for ablation procedures and its advantages and disadvantages. We also review how radiofrequency energy can be applied to treat various arrhythmias. We also discuss some of the insights that catheter ablation has in turn provided in our understanding of arrhythmias.

Electrophysiological Effects of Propofol on the Normal Cardiac Conduction System

“…In addition to its cardiac-depressant effects [1][2][3], propofol has been reported to cause profound sinus bradycardia and atrioventricular (AV) block [4][5][6][7][8][9]. However, only lim ited data exist regarding its electrophysiological proper ties [10], Several commonly administered anesthetic agents in fluence cardiac conduction by a variety of mechanisms, including direct electrophysiological effects, neurally me diated changes in autonomic nervous system tone, and indirect electrolyte and acid-base changes that accompa ny spontaneous and controlled ventilation [11], With the advent of catheter ablation procedures to treat cardiac tachyarrhythmias [12], anesthesiologists are often asked to provide sedation and, in selected patients, general anes thesia during such procedures [13], Reliable assessment of changes in the conduction properties of cardiac tissues is important during catheter ablation, and, therefore, ideal ly, the anesthetic agent used during the procedure should have a minimal or no effect on cardiac conduction proper ties. Since propofol is reported to cause bradyarrhythmias [4][5][6][7][8][9] and is frequently used in the electrophysiology labo ratory [13], we studied its electrophysiological effects in an attempt to elucidate the mechanism(s) whereby it pro duces bradyarrhythmias.…”

Application of Radiofrequency Ablation of Renal VX2 Tumors by Cooled-Tip Electrode in a Rabbit Model

“…It can produce accurately placed, small lesions in neurosurgery applications, 17,18 and can, in a similar manner, interrupt abnormal intracardioconduction pathways in cardiosurgery. 19,20 Conventional monopolar radiofrequency (RF) electrodes work well in these situations, because they can produce small and precise tissue necrotic points. Internally cooled RF electrodes, however, can create larger necrotic foci than conventional monopolar electrodes 21,22 and can, therefore, be used to destroy small tumors.…”

Exposure to extremely-low-frequency electromagnetic fields and radiofrequency radiation: cardiovascular effects in humans

“…A few in vivo animal studies are discussed in situations where human-exposure studies are not available (e.g., acute effects of RFR). This paper does not address RFR ablation of heart tissue; this topic has been reviewed elsewhere (e.g., Manolis et al 1994;Wagshal et al 1995). [Recently, Simmers et al (1996) concluded that effects of RFR ablation are exclusively thermally mediated.]…”