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Objective To discusse the mechanism and clinical significance of bradycardia -hypotension phenomenon which is caused by vagal reflex during and after the RFCA and present the experience of using appropriate measures to decrease the incidence of this situation. Methods The patients who were suffering from tachyarrhythmias and treated by RFCA were divided into two groups. The groups were as follows:148 patients who were not taken special measures in the early stage were selected in control group;1 540 patients who were taken measures to prevent vasovagal reflex were selected in observation group. Result During the RFCA, the incidence of bradycardia -hypotension phenomenon in control group was 13.5% (20/148), the incidence of bradycardia-hypotension phenomenon in observation group was 5.0%(77/1540) (<0.01) .Conclusions The incidence of bradycardia-hypotension phenomenon caused by vagal reflex during the RFCA is related to catheter irritation to the heart,pressure on the vessels and hypovolemia. The incidence of this phenomenon can be decreased obviously by some measures,such as non-restricted diet before RFCA,discretion rehydration during and after the RFCA and hemostasis with appropriate force after extubation. The key to rescue patients successfully are early detection and timely processing.
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PURPOSE: To investigate the degree of myocardial injury incurred by radiofrequency catheter ablation(RFCA), we serially measured CK, CK-MB levels in 24 pediatric paroxysmal supraventricular tachycardia patients undergoing RFCA(male : 12, female : 12, mean age : 10.5 years, mean weight : 37.2 kg). METHODS: We serially measured blood CK, CK-MB levels, 1 day before RFCA(baseline), 8 hours after RFCA(stage 1), 16 hours after RFCA(stage 2), 24 hours after RFCA. Serial changes of CK, CK-MB levels were compared with baseline levels, age, body weight, number of applied RFCAs, total duration of RFCAs and the site of ablation(left heart ablation, right heart ablation). RESULTS: Compared with baseline levels of CK, CK-MB, there were significant increases in CK and CK-MB levels in stage 1(base line : 130.7+/-54.0 U/L, 1.97+/-1.74 micro gram/L, stage 1 : 233.7+/-165.1, P=0.04, 7.71+/-7.96, P=0.01, stage 2 : 207.4+/-131.3, P=0.19, 6.51+/-8.54, P=0.08, stage 3 : 215.7+/-151.4, P=0.13, 5.09+/-4.38, P=0.36). The CK level was found to be elevated(>195 u/L) in 13 patients(54 %), while the CK-MB level was elevated(>5 micro gram/L) in 12 patients(50%). Comparing left heart ablations(n=11) and right heart ablations(n=13), CK-MB level in stage 1 was significantly increased in left heart ablation(12.29+/-9.79 micro gram/L, 3.82+/-2.48, P=0.02). In right heart ablations, there were significant correlations between the number of applied RFCAs and CK-MB level in stage 1(P=0.02, r=0.65). CONCLUSION: Significant myocardial injury was incurred by RFCA. Considering the small growing heart of pediatric patients, we should take efforts to minimize myocardial injuries.
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Female , Humans , Body Weight , Catheter Ablation , Catheters , Heart , Tachycardia, SupraventricularABSTRACT
Objective To evaluate the efficacy of radiofrequeney ablation on tachyrhythmia and cardiac acute injure.Methods Endomyocardin was signified and ablated using routine methods,the effects of radiofrequency ablation on cardiac autonomic nerve function,cardiac systolic function,radiofrequency electric injury and changes of troponin,SOD and endothelin level in pre-operation and post-operation were evaluated to study RFCA procedure caused cardiac acute injury.Results Thirty-eight patients with tachyarrhythmia underwant RFCA.The successful rate was 100%,and none had serious complications.Postoperative LF and HF were reduced significantly as compared with preoperation,Atrium and ventricle premature beats had no significant difference before and after RFCA.Cardiac systolic function had no significant changes before and after procedure,but troponin,SOD and endothelin levels were significantly higher in postoperation than those of preoperation.Conclusions RFCA is a principal therapy of tachyarrhythmia because its excellent therapeutic effect,less side effect and eradication,RFCA has acute cardiac injury,but the injury is slight.
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14 aged patients received radiofrequency current ablation(RFCA)to treat drug-refractory tachycardia. The success rate was 97%(13/14).In conjunction with the charcteristicaof aged patients often with long clinical history and apt to be complicated,the paper especially discussed the distinctive feature of application of RFCA to aged patients.
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0. 05) in rate of success, recurrence and complication between RFCA and OHO for the patients with AVRT. Medical workers were fewer, operation, du-ration, hospital days (including days of pre-operation preparation and post-operation recovery) and days of looking after the patients in RFCA were shorter than those in OHO,p