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Journal ArticleDOI

Catheter-Induced Ablation of the Atrioventricular Junction to Control Refractory Supraventricular Arrhythmias

TLDR
If this new technique involving delivery of DC shocks to an electrode catheter positioned adjacent to the His bundle proves safe and effective, it should supplant the need for open heart surgical procedures for His-bundle ablation.
Abstract
Five patients with recurrent bouts of supraventricular tachycardia proved resistant or became intolerant of both conventional and experimental drugs. These patients were subjected to a new procedure involving delivery of DC shocks to an electrode catheter positioned adjacent to the His bundle. Complete atrioventricular (AV) block was produced in all, one patient died suddenly six weeks after shock therapy, and the remainder had complete AV block with follow-up intervals ranging from four to 12 months. Shock therapy was associated with mild elevations of creatine phosphokinase MB (31 +/- 18 units), but there was no hemodynamic evidence of tricuspid insufficiency. If this new technique proves safe and effective, it should supplant the need for open heart surgical procedures for His-bundle ablation.

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Citations
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Journal ArticleDOI

Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins

TL;DR: The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation and these foci respond to treatment with radio-frequency ablation.
Journal ArticleDOI

The surgical treatment of atrial fibrillation: III. Development of a definitive surgical procedure

TL;DR: Since September 1987, this surgical procedure has been applied in seven patients and all seven patients have been cured of atrial fibrillation and none is receiving any postoperative antiarrhythmic medications.
Journal ArticleDOI

A Novel Method for Nonfluoroscopic Catheter-Based Electroanatomical Mapping of the Heart In Vitro and In Vivo Accuracy Results

TL;DR: The main shortcomings of conventional mapping-namely, prolonged x-ray exposure, low spatial resolution, and the inability to accurately navigate to a predefined site-can all be overcome with this new method.
Journal ArticleDOI

Management of Patients With Atrial Fibrillation A Statement for Healthcare Professionals From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association

TL;DR: Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice, and its incidence increases with age and the presence of structural heart disease.
Journal ArticleDOI

Right and Left Atrial Radiofrequency Catheter Therapy of Paroxysmal Atrial Fibrillation

TL;DR: This work investigated a staged anatomical approach using radiofrequency catheter ablation lines to prevent paroxysmal AF, the most common arrhythmia in women.
References
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Journal ArticleDOI

Catheter Technique for Closed-Chest Ablation of the Atrioventricular Conduction System

TL;DR: This report describes a catheter technique for ablating the His bundle and its application in nine patients with recurrent supraventricular tachycardia that was unresponsive to medical management and all patients have remained free of arrhythmia, without medication, for follow-up periods of two to six months.
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Closed-chest electrode-catheter technique for His bundle ablation in dogs

TL;DR: A modified quadripolar electrode catheter provided for a stable model of complete AV block and is suitable for experiments in which heart rate control is required and may be of value for patients with tachycardia requiring His bundle section.
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Closed chest permanent atrioventricular block in dogs

TL;DR: Ten mongrel dogs underwent transcutaneous His bundle ablation by means of pulsed synchronized electrical shocks delivered between an electrode catheter adjacent to the His bundle and a metal plate behind the dog's back, resulting in complete AV block with typical features of an infranodal pacemaker and correlated with the histologic findings of severe damage to the AV junction.
Journal ArticleDOI

Differentiation of "A-V Junctional Rhythms"

TL;DR: Evidence gained from experimental in vivo and in vitro animal studies and from clinical investigations clearly suggests the existence of at least two pacemakers in the A-V junction.
Journal ArticleDOI

A study of methods for surgical interruption of the His bundle.

TL;DR: A series of experiments were carried out for interruption of atrial to ventricular conduction that included electrocauterization of the His bundle, incision just above the tricuspid annulus, and excision of the right atrial wall and the insertion of the atrial septum into the right fibrous trigone to remove all connections from the AV node and atrium to the His Bundle.
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