Transvenous Radiofrequency Ablation Therapy in the Treatment of Arrhythmias: A Single Center Experience

Yıl 2013, Cilt: 16 Sayı: 1, 36 - 41, 01.01.2012

Tayyar Gökdeniz Ahmet Çağrı Aykan Mustafa Yıldız Şükrü Çelik

https://doi.org/10.5578/kkd.4475

Öz

Introduction: Radiofrequency ablation of tachyarrhythmia is effective in the treatment of tachycardia. In this study, we evaluated the results of radiofrequency catheter ablation of tachyarrhythmia. Patients and Methods: From December 2010 to January 2012, 114 consecutive patients with symptomatic drug-resistant typical slow-fast atrioventricular nodal reentrant tachycardia, 17 patients with atrioventricular reentrant tachycardia (five Wolf Parkinson White syndrome), eight patients with atrial tachycardia, seven patients with atrial flutter, five patients with right ventricular outflow tract tachycardia and three patients with atrial fibrillation underwent an invasive electrophysiology study and radiofrequency ablation. Results: The 154 patients (age: 39.1 ± 17.2 years, body mass index: 24.3 ± 5.2 kg/m2, waist/ hip ratio: 0.88 ± 5.2, systolic blood pressure: 128.3 ± 22.4 mmHg, diastolic blood pressure: 75.30 ± 9.0 mmHg, resting heart rate: 76.10 ± 8.2 beat/minute) with tachycardia (89 women, 65 men) were ablated. Procedure and fluoroscopy times were 57.5 ± 19.0 and 14.4 ± 4.1 minute respectively. The mean follow up period was 10.2 ± 4.3 months. During follow up period three patients with atrioventricular nodal reentrant tachycardia, two patients with atrioventricular reentrant tachycardia, one patient with right ventricular outflow tract tachycardia and one patient with atrial fibrillation had recurrence. Conclusion: The transvenous radiofrequency ablation therapy is a safe and effective approach for the treatment of tachyarrhythmia under experienced hands.

Anahtar Kelimeler

Catheter ablation, radiofrequency; ablation techniques; arrhythmias, cardiac.

Aritmilerin Tedavisinde Transvenöz Radyofrekans Ablasyon Tedavisi: Tek Merkez Deneyimi

Öz

Giriş: Radyofrekans ablasyon taşiaritmilerin tedavisinde etkin bir yöntemdir. Bizler bu çalışmada taşikardilerin tedavisinde radyofrekans kateter ablasyonunun sonuçlarını araştırdık. Hastalar ve Yöntem: Aralık 2010 ile Ocak 2012 tarihleri arasında invaziv elektrofizyolojik girişim ve radyofrekans kateter ablasyonu yapılan ardışık semptomatik olan ve ilaç tedavisine dirençli atriyoventriküler nodal reentrant taşikardili 114 hasta, atriyoventriküler reentrant taşikardili (AVRT) 17 hasta (beş Wolf Parkinson White sendrom), atriyal taşikardili sekiz hasta, atriyal flattırlı yedi hasta, sağ ventrikül çıkış yolu kaynaklı taşikardisi olan beş hasta ve atriyal fibrilasyonu olan üç hasta çalışmaya dahil edildi. Bulgular: Taşikardisi olan 154 hastaya ablasyon tedavisi uygulandı (yaş: 39.1 ± 17.2 yıl, beden kitle indeksi: 24.3 ± 5.2 kg/m2, bel/kalça oranı: 0.88 ± 5.2, sistolik kan basıncı: 128.3 ± 22.4 mmHg, diyastolik kan basıncı: 75.30 ± 9.0 mmHg, dinlenme kalp hızı: 76.10 ± 8.2 beat/ dakika, 89 kadın 65 erkek). İşlem ve floroskopi süreleri sırasıyla 57.5 ± 19.0 ve 14.4 ± 4.1 dakikaydı. Ortalama takip süresi 10.2 ± 4.3 aydı. Takip süresince atriyoventriküler nodal reentrant taşikardili üç, atriyoventriküler reentrant taşikardili iki, sağ ventrikül çıkış yolu taşikardili bir ve atriyal fibrilasyonlu bir hastada rekürrens gelişti. Sonuç: Transvenöz radyofrekans ablasyon tedavisi deneyimli ellerde taşiaritmilerin tedavisi için güvenli ve etkin bir yöntemdir.

Anahtar Kelimeler

Radyofrekans, ablasyon, aritmi.

Kaynakça

• Yıldız M, Aykan AC, Kahveci G, Demir S, Ozkan M. Transvenous radiofrequency ablation theraphy as an effective and safe method for the treatment of the slow pathway of atrioventricular nodal re- entrant tachycardia. Kosuyolu Kalp Derg 2011;14:51-5.
• Jackman WM, Beckman KJ, McClelland JH, Wang X, Friday KJ, Roman CA, et al. Treatment of supraventricular tachycardia due to atrioventricular nodal reentry, by radiofrequency catheter ablation of slow-pathway conduction. N Engl J Med 1992;327:313-8.
• Giazitzoglou E, Korovesis S, Kokladi M, Venetsanakos I, Paxinos G, Katritsis DG. Slow-pathway ablation for atrioventricular nodal re-entrant tachycardia with no risk of atrioventricular block. Hel- lenic J Cardiol 2010;51:407-12.
• Spector P, Reynolds MR, Calkins H, Sondhi M, Xu Y, Martin A, et al. Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. Am J Cardiol 2009;104:671-7.
• Reithmann C, Hoffmann E, Grünewald A, Nimmermann P, Remp T, Dorwarth U, et al. Fast pathway ablation in patients with com- mon atrioventricular nodal reentrant tachycardia and prolonged PR interval during sinus rhythm. Eur Heart J 1998;19:929-35.
• Li YG, Grönefeld G, Bender B, Machura C, Hohnloser SH. Risk of development of delayed atrioventricular block after slow path- way modification in patients with atrioventricular nodal re-entrant tachycardia and a pre-existing prolonged PR interval. Eur Heart J 2001;22:89-95.
• Papez AL, Al-Ahdab M, Dick M 2nd, Fischbach PS. Transcatheter cryotherapy for the treatment of supraventricular tachyarrhythmias in children: a single center experience. J Interv Card Electrophys- iol 2006;15:191-6.
• Calkins H, Yong P, Miller JM, Olshansky B, Carlson M, Saul JP, et al. Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multi- center Investigators Group. Circulation 1999;99:262-70.
• Lesh MD, Van Hare GF, Epstein LM, Fitzpatrick AP, Scheinman MM, Lee RJ, et al. Radiofrequency catheter ablation of atrial ar- rhythmias. Results and mechanisms. Circulation 1994;89:1074- 89.