Clinical, electrophysiological characteristics, and radiofrequency catheter ablation of atrial tachycardia near the apex of Koch's triangle

被引:44
作者
Lai, LP
Lin, JL
Chen, TF
Ko, WC
Lien, WP
机构
[1] Natl Taiwan Univ Hosp, Dept Internal Med, Cardiol Sect, Taipei, Taiwan
[2] Taipei Prov Hosp, Dept Internal Med, Taipei, Taiwan
[3] Cathay Gen Hosp, Dept Internal Med, Taipei, Taiwan
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 1998年 / 21卷 / 02期
关键词
atrial tachycardia; catheter ablation; Koch's triangle;
D O I
10.1111/j.1540-8159.1998.tb00060.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Atrial tachycardia, with its focus near the apex of Koch's triangle, may carry a potential risk of atrioventricular block during radiofrequency catheter ablation. The efficacy and safety of this procedure have never been addressed. The characteristics and catheter ablation results are reported for six patients with atrial tachycardia near the apex of Koch's triangle. All six-patients were female aged 49.6 +/- 9.3 years (range 39-63). Organic heart disease was present in 3 (50%) of the 6 patients. The P wave in surface ECG had a mean axis of -28 degrees (range -90 degrees - +30 degrees) in the frontal plane. The catheter ablation was guided by activation sequence mapping. The energy was titrated from low power level. Atrial overdrive pacing was used to monitor the atrioventricular conduction should accelerated junctional rhythm occur. At the final successful ablation site, the local atrial activation was 41.8 +/- 9.1 ms before the P wave and His-bundle potential was present in 5 of the 6 patients. All patients had their atrial tachycardia eliminated without recurrence or heart block during a follow-up period of 17.7 +/- 8.5 months (range 6-30). In conclusion, atrial tachycardia near the apex of Koch's triangle has distinct clinical and electrophysiological features. Radiofrequency catheter ablation can be performed effectively. However, extreme care must be taken to prevent inadvertent atrioventricular block. Titrated energy application and continuous monitoring of atrioventricular conduction are mandatory.
引用
收藏
页码:367 / 374
页数:8
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