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- Hill, JA, et al.
(författare)
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Medical misinformation: Vet the message!
- 2019
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Ingår i: Heart rhythm. - : Elsevier BV. - 1556-3871 .- 1547-5271. ; 16:3, s. 332-333
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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- Kesek, Milos, et al.
(författare)
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Increased risk of late pacemaker implantation after ablation for atrioventricular nodal reentry tachycardia : A 10-year follow-up of a nationwide cohort
- 2019
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Ingår i: Heart Rhythm. - : Elsevier. - 1547-5271 .- 1556-3871. ; 16:8, s. 1182-1188
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Tidskriftsartikel (refereegranskat)abstract
- Background: Catheter ablation of the slow pathway is the standard treatment of atrioventricular nodal reentry tachycardia (AVNRT) with a well described low risk of periprocedural atrioventricular block. Less is known about the risk of pacemaker implantation late after ablation.Objective: We aimed to quantify the risk of late pacemaker implantation in a countrywide cohort undergoing first-time ablation for AVNRT.Methods: All patients undergoing first-time ablation for AVNRT in Sweden from 2004 to 2014 were identified from the Swedish catheter ablation registry and matched against the Swedish Pacemaker and ICD registry. The cohort was compared to patients ablated for an accessory pathway (AP) and to matched controls.Results: During follow-up of 2039 days, pacemaker was implanted later than 30 days after ablation in 96 of 6842 patients with AVNRT (1.4%), 29 of 4065 patients with AP (0.7%) (P = .001), and 124 of 33,270 controls (0.4%) (P < .00001). A periprocedural pacemaker (≤30 days postablation) was implanted in 32 of 6877 patients with AVNRT (0.5%) and 9 of 4079 patients with AP (0.2%) (P = .05). With cryoablation, 5 patients needed periprocedural pacemaker implantation. Pacemakers were implanted before ablation in 88 of 6977 patients with AVNRT (1.3%) and 11 of 4100 patients with AP (0.3%); the prevalence of pacemaker implants in controls was 124 of 33,270 (0.4%) (P < .00001 for both comparisons).Conclusion: The risk of late pacemaker implantation after AVNRT ablation was low but 3 times higher than that in the control population and 3 times higher than the risk of periprocedural pacemaker implantation. Similar results were observed with cryoablation and radiofrequency ablation. Ablation may not be the cause of increased late pacemaker implantation risk.
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- Squara, Fabien, et al.
(författare)
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Electrical connection between ipsilateral pulmonary veins : prevalence and implications for ablation and adenosine testing.
- 2015
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Ingår i: Heart Rhythm. - : Elsevier BV. - 1547-5271 .- 1556-3871. ; 12:2, s. 275-82
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Anatomic studies have reported the presence of shared myocardial fibers between approximately half of ipsilateral pulmonary veins (IPVs).OBJECTIVE: The purpose of this study was to assess the prevalence of electrical connection between IPVs and the impact of antral isolation with or without carina ablation on IPV connection.METHODS: Thirty consecutive patients undergoing atrial fibrillation (AF) ablation (14 redo) were included. Wide antral pulmonary vein isolation (PVI) was performed with or without carina lesions. For each PV set, IPV electrical connection was assessed before and after PVI by pacing and recording from the ostium of both IPVs using a circular mapping catheter and the ablation catheter. Adenosine was given after PVI to assess for acute PV reconnection.RESULTS: Before PVI without preceding AF ablation procedure, all the PVs had ipsilateral connection albeit frequently via the left atrium. After PVI, 65.6% of the IPVs were connected without carina ablation vs 17.7% if prior carina ablation (P = .001). Left vs right IPVs were connected in 57.1% and 72.2% of the cases without carina ablation, respectively, vs 30% and 0% of cases with carina ablation (P = .19 and P = .001). When transient PV reconnection was demonstrated during adenosine challenge, connected IPVs uniformly demonstrated simultaneous reconnection.CONCLUSION: Electrical connection between IPVs is uniformly demonstrated before any ablation. Two-thirds of the IPVs are connected after antral PVI, and carina ablation decreases IPV connection. Connected IPVs consistently show the same response to adenosine challenge; therefore, a single catheter positioned in either of the IPVs with electrical connection is sufficient to confirm reconnection in both veins.
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