RESUMO
We report our experience regarding definitive treatment for concurrent atrioventricular reciprocating and AV node reentry tachycardia in 184 consecutive patients undergoing accessory connection ablation. 18 patients also had inducible sustained AV node reentry tachycardia. Sixteen out of 18 patients underwent accessory connection albation followed by AV node modification. There were no complications related to the ablation procedures. Fluoroscopy time for the combined procedures was 29 +/- 12 minut. There were no tachycardia recrrences during follow-up of 21 +/- 11 months. Our data show that both accessory connection ablation and AV node modification can be effectively and safely performed in a single procedure.
Assuntos
Arritmias Cardíacas , Eletrocoagulação , Taquicardia , Taquicardia por Reentrada no Nó SinoatrialRESUMO
Recent reports have emphasized the usefulness of programmed electrical stimulation of the heart for predicting the effectiveness of pharmacologic therapy of recurrent tachycardias and for determining the basis of recurrent palpitations. We used programmed electrical stimulation of the atrium from the esophagus to study 12 children (ages 1 to 13 years) with either electrocardiographically documented tachycardia (seven patients) or recurrent palpitations (five patients). Atrial stimulation from the esophagus initiated and terminated tachycardia in all seven patients who had a previously documented tachycardia. In five of these patients tachycardia could not be initiated after therapy with quinidine sulfate, and no recurrences have been noted in 12 to 18 months of follow-up. In two patients tachycardia could be reinitiated despite therapeutic quinidine levels, and tachycardia has recurred despite quinidine therapy. Atrial stimulation from the esophagus initiated tachycardia in four of five patients with a history of palpitations. Electrocardiographic documentation of tachycardia was beneficial, because it provided a basis for determining whether therapy for tachycardia was indicated, and in some instances provided an opportunity for patient education to permit-self termination without medication.