RESUMO
There is a paucity of data comparing irrigated to non-irrigated catheters in the ablation of accessory pathways (AP) in adult patients. Retrospective analysis of first-time AP ablations performed at our institution from May 2010 to June 2017. A total of 69 AP ablations were studied; irrigated catheters were used in 78.3% cases. Mean age was 40.9 ± 14.3 years and 56.7% were male. Among APs, 63.8% were left sided and 56.5% were concealed. The total procedure time was 232.0 ± 89.0 min, ablation time was 3.1 ± 5.1 min, and fluoroscopy time was 13.9 ± 15.4 min. The overall acute success rate of ablation was 62/69 (89%). Success rates trended higher with irrigated catheters in both groups and were significant for the population as a whole (94.4% vs. 73.3%, p = 0.04). Analyzing the entire cohort, success rates were significantly higher in ablations using irrigated catheters.
Assuntos
Feixe Acessório Atrioventricular/cirurgia , Arritmias Cardíacas/cirurgia , Cateterismo Cardíaco/instrumentação , Cateteres Cardíacos , Ablação por Cateter/instrumentação , Irrigação Terapêutica/instrumentação , Feixe Acessório Atrioventricular/fisiopatologia , Potenciais de Ação , Adulto , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatologia , Cateterismo Cardíaco/efeitos adversos , Ablação por Cateter/efeitos adversos , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Irrigação Terapêutica/efeitos adversos , Resultado do Tratamento , Adulto JovemRESUMO
A 60-year-old male with a history of prior ablation of typical cavotricuspid isthmus-dependent atrial flutter presented to us with recurrent palpitations. The surface 12-lead EKG was consistent with atrial tachycardia, for which an ablation was planned. The patient was found to have multiple marcroreentrant left atrial tachycardias utilizing areas of scar as substrate. Isthmuses of tissue with fractionated electrograms associated with scar were targeted for ablation.
