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  • 2005-2009  (2)
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  • 2005-2009  (2)
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  • 1
    In: Journal of Cardiovascular Electrophysiology, Wiley, Vol. 17, No. 8 ( 2006-08), p. 847-851
    Kurzfassung: Background: AV node slow pathway conduction can persist following successful ablation for AV node reentrant tachycardia (AVNRT). We hypothesized that careful examination of AV nodal conduction curves before and after effective AVNRT ablation in patients with persistent slow pathway conduction could shed light on this apparent paradox. Methods and Results: Thirty patients (age 40.9 ± 14.3; 8 male) were included. AV node function curves were created based on pre‐ and postablation atrial extrastimulus testing. Analysis of slow pathway function curves demonstrated significant decrease in AH for any given coupling interval after ablation (mean difference –68.1 [–94.5, –41.7] P 〈 0.001), graphically indicated by downward displacement of the curve. In addition, mean slow pathway effective refractory period (ERP) increased from 247.9 ± 36.1 msec to 288.6 ± 56.0 msec (P 〈 0.001); mean maximum AH interval decreased from 361.3 ± 114.2 msec to 306.9 ± 65.2 msec (P = 0.013 ) ; mean difference in minimum and maximum AH interval during slow pathway conduction decreased (from 94.5 ± 75.8 msec to 59.6 ± 46.2 msec (P = 0.016 ). Finally, mean difference between the fast and slow pathway effective refractory periods, the span of coupling intervals over which slow pathway conduction occurred, decreased (from 113.9 ± 61.4 msec to 63.2 ± 41.5 msec, P = 0.001). Conclusions: Ablation, which successfully eliminates inducible and spontaneous AVNRT in the presence of persistent slow pathway conduction, is associated with significantly altered slow pathway conduction characteristics, indicating the presence of a damaged or different slow pathway after ablation, incapable of sustaining tachycardia.
    Materialart: Online-Ressource
    ISSN: 1045-3873 , 1540-8167
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2006
    ZDB Id: 2037519-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Wiley ; 2005
    In:  Journal of Cardiovascular Electrophysiology Vol. 16, No. 6 ( 2005-06), p. 589-593
    In: Journal of Cardiovascular Electrophysiology, Wiley, Vol. 16, No. 6 ( 2005-06), p. 589-593
    Kurzfassung: Introduction: Ablative strategies for atrial fibrillation have centered on the left atrium, in particular the pulmonary veins. An emphasis on ablating outside the ostia of the pulmonary veins appears to have reduced the risk of pulmonary vein stenosis. Unfortunately, ablation in the posterior left atrium has been reported to result in fatal atrio‐esophageal fistula. Methods and Results: We monitored esophageal temperatures in 16 consecutive patients undergoing atrial fibrillation ablation. There were 14 men and 2 women; average age 54.7 ± 10.6 years. Eight patients had a lasso‐guided pulmonary isolation procedure, eight an electroanatomically guided left‐atrial circumferential approach. A commercially available esophageal temperature probe (Mallinckrodt Mon‐a‐therm 12F Esophageal Stethoscope with Temperature Sensor, Thermistor 400 Series) was positioned under general anesthesia. Temperature changes were noted and related to the relative location of the ablation catheter and the temperature probe during the temperature change. The esophagus was midline in three, right sided in three, and left sided in the remaining patients. Temperature rises could be recorded at the posterior aspect of any pulmonary vein. Detailed analysis of six patient maps revealed heating occurred with lesions created within 1 cm of the esophagus. Conclusion: The location of the esophagus relative to the back of the left atrium displays considerable variability. It is rarely midline and most often lies in close proximity to the left‐sided veins. Ablation in close radiographic proximity (approximately 1 cm) to the esophagus as defined by a radio‐opaque temperature probe can result in heating at the esophageal lumen.
    Materialart: Online-Ressource
    ISSN: 1045-3873 , 1540-8167
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2005
    ZDB Id: 2037519-0
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
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