DISSOCIATION OF ATRIOVENTRICULAR-CONDUCTION AND REFRACTORINESS FOLLOWING APPLICATION OF RADIOFREQUENCY ENERGY TO THE CANINE ATRIOVENTRICULAR NODE - ACUTE AND CHRONIC OBSERVATIONS

被引:3
作者
MARCUS, FI [1 ]
BLOUIN, LT [1 ]
BHARATI, S [1 ]
LEV, M [1 ]
HAHN, E [1 ]
机构
[1] CHRIST HOSP,HEART INST CHILDREN,CTR CONGENITAL & CONDUCT SYST,OAK LAWN,IL
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 1992年 / 15卷 / 11期
关键词
AV NODE MODIFICATION; RADIOFREQUENCY ENERGY; CATHETER ABLATION; AV NODE PHYSIOLOGY; ATRIAL FIBRILLATION; SUPRAVENTRICULAR TACHYCARDIA;
D O I
10.1111/j.1540-8159.1992.tb02958.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The electrophysiology of AV nodal modification induced by radiofrequency energy (n = 5) or a sham procedure (n = 5) was studied in ten dogs. The five dogs that received radiofrequency energy had an AH prolongation > 100% from baseline values and this prolongation persisted throughout the 2-month study. The AV nodal functional refractory period was prolonged only acutely. These data indicate a dissociation between the effects on AV nodal conduction and refractoriness that was induced by this procedure. The five sham treated controls showed no acute or chronic electrophysiological changes. In the dogs that received radiofrequency energy, there was fibrosis of the approaches to the AV node and the region of the AV node itself. It is concluded that chronic modification of AV nodal conduction without concomitant changes in refractoriness can be induced by radiofrequency energy delivered in the proximal portion of the AV node. It would be anticipated that this procedure would not decrease the ventricular response to atrial fibrillation or flutter, but may be effective in preventing AV nodal reentrant tachycardia by interfering with conduction either in the AV node or perinodal region. Since the AV node itself suffers at least moderate pathological damage, there may be an appreciable incidence of the late development of complete heart block after this procedure.
引用
收藏
页码:1702 / 1710
页数:9
相关论文
共 35 条
[1]   CRYOSURGERY IN TACHYCARDIA TREATMENT [J].
BREDIKIS, JJ ;
BUKAUSKAS, FF ;
LEKAS, RI ;
SAKALAUSKAS, JJ ;
BREDIKIS, AJ ;
LAURUSHONIS, KA ;
PUTELIS, RA ;
TURKEVICHIUS, GS .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1986, 9 (06) :1403-1406
[2]   CRYOSURGICAL TREATMENT OF ATRIOVENTRICULAR NODE REENTRANT TACHYCARDIA [J].
COX, JL ;
HOLMAN, WL ;
CAIN, ME .
CIRCULATION, 1987, 76 (06) :1329-1336
[3]  
COX JL, 1990, J THORAC CARDIOV SUR, V99, P440
[4]  
CRITELLI G, 1983, BRIT HEART J, V49, P544
[5]   PERCUTANEOUS CATHETER MODIFICATION OF THE ATRIOVENTRICULAR NODE - A POTENTIAL CURE FOR ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA [J].
EPSTEIN, LM ;
SCHEINMAN, MM ;
LANGBERG, JJ ;
CHILSON, D ;
GOLDBERG, HR ;
GRIFFIN, JC .
CIRCULATION, 1989, 80 (04) :757-768
[6]   CATHETER ABLATION OF CANINE MYOCARDIUM WITH RADIOFREQUENCY ENERGY [J].
FRANKLIN, JO ;
LANGBERG, JJ ;
OEFF, M ;
FINKBEINER, WE ;
HERRE, JM ;
GRIFFIN, JC ;
SCHEINMAN, MM .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1989, 12 (01) :170-176
[7]   OPERATIVE THERAPY OF ATRIOVENTRICULAR NODE REENTRY AND RESULTS OF AN ANATOMICALLY GUIDED PROCEDURE [J].
FUJIMURA, O ;
GUIRAUDON, GM ;
YEE, R ;
SHARMA, AD ;
KLEIN, GJ .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 64 (19) :1327-1332
[8]   FULGURATION FOR AV NODAL TACHYCARDIA - RESULTS IN 42 PATIENTS WITH AMEAN FOLLOW-UP OF 23 MONTHS [J].
HAISSAGUERRE, M ;
WARIN, JF ;
DIVERNOIS, C ;
LEMETAYER, PH ;
MONTSERRAT, P .
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 1990, 13 (12) :2000-2007
[9]   CLOSED-CHEST ABLATION OF RETROGRADE CONDUCTION IN PATIENTS WITH ATRIOVENTRICULAR NODAL REENTRANT TACHYCARDIA [J].
HAISSAGUERRE, M ;
WARIN, JF ;
LEMETAYER, P ;
SAOUDI, N ;
GUILLEM, JP ;
BLANCHOT, P .
NEW ENGLAND JOURNAL OF MEDICINE, 1989, 320 (07) :426-433
[10]  
HOFFMAN E, 1989, PACE, V12, P1283