Radiofrequency Ablation Of Arrhythmias Research Articles

Management of cardiovascular conditions in a cohort of patients with HIV: experience from a joint HIV/cardiology clinic

The aim of this study was to assess cardiovascular diagnoses and management in a cohort of patients diagnosed with HIV, and the performance of a joint HIV/Cardiology Clinic in a tertiary hospital setting. A retrospective analysis was performed on all patients referred to a joint HIV/Cardiology Clinic at our hospital. Data on 120 patients were collected. In this predominantly male population (male 101 and female 19) coronary artery disease (CAD) was the most common diagnosis (34%, n = 41). Other diseases included hypertension (12.5%, n = 15), cardiomyopathy (12.5%, n = 15) and arrhythmia (6%, n = 8). The majority of remaining cases included non-cardiac chest pain and palpitations. In addition to usual primary and secondary preventive measures for CAD, complex procedures, such as percutaneous coronary intervention, cardiac resynchronisation therapy for left ventricular systolic dysfunction and radiofrequency ablation for arrhythmias, were carried out. Overall cardiovascular mortality among the group was 2.5% (n = 3) over 4 years. The results indicate the efficacy of a specialist joint HIV/Cardiology Clinic in diagnosing and managing various cardiac conditions in a complex cohort of patients with HIV.

GW26-e4554 The Clinical Study of Under the Guidance of The New Three - Dimensional Mapping for Radiofrequency Ablation of Arrhythmias

GW26-e4554 The Clinical Study of Under the Guidance of The New Three - Dimensional Mapping for Radiofrequency Ablation of Arrhythmias

Electrophysiology assessment and radiofrequency ablation of arrhythmias in adult patients with congenital heart defects: The Christchurch experience

Adults with congenital heart disease (CHD) frequently have cardiac arrhythmias, many of which are best treated with radiofrequency ablation (RFA). We present our experience in this group.Retrospective chart based review of diagnosis, arrhythmia type, results of cardiac electrophysiological assessment, and procedural and long-term clinical success of radiofrequency ablation.Forty-five patients were identified with CHD and arrhythmias undergoing RFA; including surgically repaired atrial septal defects (21), Ebstein's anomaly (12), repaired transposition of the great arteries (3), repaired Tetralogy of Fallot (4), repaired ventricular septal defect (3), repaired coarctation (1) and unrepaired anomalous pulmonary venous anatomy (1). Arrhythmias were atrial flutter (24), atrial fibrillation (1), atrial tachycardia (3), atrioventricular nodal re-entrant tachycardia (5), and atrioventricular re-entrant tachycardia (12). Procedural success was ultimately obtained in 36 patients, with 6 having unsuccessful ablation and 3 an undetermined result. Twelve patients required a repeat procedure. One patient required a third procedure and had insertion of permanent pacemaker and atrioventricular nodal ablation. With follow-up (range 2-264 months) 31 patients (69%) remained in sinus rhythm, 9 have developed atrial fibrillation, 3 are in atrial flutter or atrial tachycardia, 1 patient reports ongoing palpitations with no documented arrhythmia and 1 patient has died. Procedural complications were major venous access bleeding (2), transient heart block during slow pathway ablation with late complete heart block (1).The majority of arrhythmias in adult patients with congenital heart defects can be successfully treated with radiofrequency ablation at a relatively low risk.

Renal Denervation by Ablation with Innovative Technique in Resistant Hypertension

Hypertension is the cause of thousands of deaths annually1, and half of the patients treated present controlled blood pressure (BP)2. Resistant hypertension (RH)is defined when the BP remains above the recommended targets with the use of three antihypertensive drugs with synergistic actions at maximum doses recommended and tolerated, preferably one being a diuretic, or when in use of four or more anti-hypertensive drugs, even with controlled BP3. It is estimated that 12%-15% of persons with hypertension are considered resistant, with high risk of cardiovascular morbidity and mortality4. The pathogenesis of hypertension is multifactorial, but the sympathetic activity plays an important role, especially in patients with resistant hypertension2. Efferent renal sympathetic activity stimulates renin release, increases sodium reabsorption and reduces renal blood flow and may be a mechanism for the development and maintenance of hypertension2. Genetic, behavioral and environmental factors influence increased sympathetic activity in persons with hypertension5. New therapies aiming to reduce sympathetic activity have been developed. Renal Sympathetic Denervation (RSD) by radiofrequency catheter ablation of renal arteries has been shown to control BP in resistant hypertension6,7 and in associated clinical conditions such as sleep destructive apnea8 and insulin resistance9. The main RSD clinical studies used a specific catheter not yet available in Brazil, but the radiofrequency ablation of arrhythmias is a procedure that has been performed by electrophysiologists through appropriate catheters for years in our country. Experimental studies of RSD with catheters used for ablation of arrhythmias indicated the possibility of using these to replace those used in international studies, considering the unavailability of those in our reality. Based on this, for the procedure to be reported, the model used for ablation in children (4 mm tip and 5F), which was proven to be more appropriate, was chosen. The objective of the report is to show the result of the first RSD in our community, with the aid of technology used in cardiac arrhythmias.

Early Diagnosis and Rescue Pericardiocentesis for Acute Cardiac Tamponade during Radiofrequency Ablation for Arrhythmias. Is Fluoroscopy Enough?

With the number of complex catheter ablation procedures increasing, procedure-related acute cardiac tamponade is encountered more frequently in the cardiac catheterization laboratory. Survival depends on prompt recognition and rescue pericardiocentesis. The aim of this report was to validate fluoroscopic heart silhouette characteristics associated with cardiac tamponade as a diagnostic method, and evaluate the safety and effectiveness of fluoroscopy-guided pericardiocentesis during catheter ablation. All cases of acute cardiac tamponade that occurred in the cardiac catheterization laboratory during radiofrequency catheter ablation from March 2004 to November 2009 were reviewed retrospectively. Of 1,832 catheter ablation procedures performed during a 5-year period, 10 (0.55%) were complicated by cardiac tamponade. Fluoroscopic examination confirmed the diagnosis in all 10 patients and demonstrated effusions before hypotension in four patients. All patients were stabilized by fluoroscopy-guided pericardiocentesis with placement of an indwelling catheter and autologous transfusion. The time interval between recognition of cardiac tamponade and completion of pericardiocentesis was 6.0 ± 1.8 minutes (range 3-9 minutes). The mean aspirated blood volume was 437 mL (range 110-1,400 mL), and the mean autotransfused blood volume was 425 mL (range 100-1,384 mL). Surgical repair of the cardiac perforation was needed in one patient. No procedure-related death occurred. A reduction in the excursion of cardiac silhouette on fluoroscopy is an early diagnostic sign of cardiac tamponade during radiofrequency ablation. Fluoroscopy-guided pericardiocentesis is a safe and effective management strategy for cardiac tamponade developed in the cardiac catheterization laboratory.

E0567 Early diagnosis and rescue pericardiocentesis for acute cardiac tamponade during radiofrequency ablation for arrhythmias, Is fluoroscopy enough?

BackgroundWith the number of complex catheter ablation procedures increasing, procedure-related acute cardiac tamponade is encountered more frequently in the cardiac catheterisation laboratory. Survival depends on prompt recognisation and rescue pericardiocentesis.ObjectiveThe...

INTERVENTIONAL PROCEDURES FOR CONGENITAL HEART DISEASE

Interventional techniques available for use in treating congenital heart disease include balloon dilation of valves and vessels, stent placement and coil embolization of collaterals, patent ducts and other arterial fistulae. In addition, a variety of devices for closure of atrial and ventricular septal defects and patent ducts currently are under investigation. Radiofrequency ablation of arrhythmias also is applicable to the pediatric population.

Quantity and Quality Relationships in Cardiovascular Medicine

Hospital volume and often also operator volume have documented impacts on the quality of care for aortic and aortocoronary bypass surgery, for percutaneous angioplasty and for radiofrequency ablation for arrhythmias, whereas data are less consistent for treatment of acute myocardial infarction. A review of this research is given. In the Nordic countries hospitals are small, and often the plateau of the learning curve cannot be reached. To discourage low-volume centers from embarking upon too complicated interventional or surgical procedures, the author suggests that a minimal number should be set for certain major procedures, both for hospitals and for physicians.

Identification of small myocardial injury by Tc-99m pyrophosphate spect in patients undergoing radiofrequency ablation of arrhythmia

Identification of small myocardial injury by Tc-99m pyrophosphate spect in patients undergoing radiofrequency ablation of arrhythmia

Radiofrequency ablation of arrhythmias in the pediatric patient

Advances in management of pediatric arrhythmias using radiofrequency catheter ablation are reviewed. Discussion begins with the most frequent arrhythmia experienced in childhood, supraventricular tachycardia, and its variants. Subsequent consideration will center on progress made in using radiofrequency catheter ablation to manage ventricular tachycardia, both in the normal heart as well as in surgically repaired tetralogy of Fallot. Potential limitations to radiofrequency ablation in the infant age group are addressed. Technologic progress as it applies to pediatric patients is also examined. Lastly, an enhanced appreciation for the immense contribution that radiofrequency catheter ablation techniques have made will emerge for the reader after reviewing recent results obtained using surgical techniques for arrhythmia ablation.