Abstract
Drug-resistant atrial flutter (AF) is a clinical problem mainly when it is associated with fast ventricular rate or severe heart disease. Endocardial mapping of AF can identify the critical slow conduction area of the reentrant circuit; localized intervention in this area with radiofrequency (RF) energy could modify AF. Eight pts (mean age 56 ± 13 years) were referred for extremely symptomatic, recurrent AF which was resistant to antiarrhythmic drugs (1A, 1C, Sotalol, Amiodarone) used in combination. In 1 pt type I AF was present, in 6 pts type I and II AF was observed, in 1 pt the type was not identifiable. We delivered several RF impulses (10-25 W for 5-10 sec) to the area of slow conduction by means of the distal electrode of a 4-polar lead used in unipolar configuration. In 7 pts RF terminated AF within 24 hours after the procedure without any complication. During the follow-up (range 4-15 months), 6 pts had not AF recurrences; in 1 pt AF resumed 13 months later, in 1 pt stable atrial fibrillation developed, all of them were symptom-free. Three pts were on antiarrhythmic drugs (2 on Amiodarone for ventricular arrhythmias, 1 on Amiodarone and Sotalol for episodes of non sustained atrial fibrillation). We suggest that localized ablation of slow conduction area of the reentrant circuit may have a role in the treatment of drug-resistant AF without the need for nodal ablation and permanent pacemaker.
| Original language | English |
|---|---|
| Pages (from-to) | 481-486 |
| Number of pages | 6 |
| Journal | New Trends in Arrhythmias |
| Volume | 8 |
| Issue number | 1-2 |
| Publication status | Published - 1992 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy. / Ambrosini, F.; Arlotti, M.; Landolina, M.; Manfredini, R.; Broglia, P.; Sernesi, L.; Lotto, A.
In: New Trends in Arrhythmias, Vol. 8, No. 1-2, 1992, p. 481-486.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy
AU - Ambrosini, F.
AU - Arlotti, M.
AU - Landolina, M.
AU - Manfredini, R.
AU - Broglia, P.
AU - Sernesi, L.
AU - Lotto, A.
PY - 1992
Y1 - 1992
N2 - Drug-resistant atrial flutter (AF) is a clinical problem mainly when it is associated with fast ventricular rate or severe heart disease. Endocardial mapping of AF can identify the critical slow conduction area of the reentrant circuit; localized intervention in this area with radiofrequency (RF) energy could modify AF. Eight pts (mean age 56 ± 13 years) were referred for extremely symptomatic, recurrent AF which was resistant to antiarrhythmic drugs (1A, 1C, Sotalol, Amiodarone) used in combination. In 1 pt type I AF was present, in 6 pts type I and II AF was observed, in 1 pt the type was not identifiable. We delivered several RF impulses (10-25 W for 5-10 sec) to the area of slow conduction by means of the distal electrode of a 4-polar lead used in unipolar configuration. In 7 pts RF terminated AF within 24 hours after the procedure without any complication. During the follow-up (range 4-15 months), 6 pts had not AF recurrences; in 1 pt AF resumed 13 months later, in 1 pt stable atrial fibrillation developed, all of them were symptom-free. Three pts were on antiarrhythmic drugs (2 on Amiodarone for ventricular arrhythmias, 1 on Amiodarone and Sotalol for episodes of non sustained atrial fibrillation). We suggest that localized ablation of slow conduction area of the reentrant circuit may have a role in the treatment of drug-resistant AF without the need for nodal ablation and permanent pacemaker.
AB - Drug-resistant atrial flutter (AF) is a clinical problem mainly when it is associated with fast ventricular rate or severe heart disease. Endocardial mapping of AF can identify the critical slow conduction area of the reentrant circuit; localized intervention in this area with radiofrequency (RF) energy could modify AF. Eight pts (mean age 56 ± 13 years) were referred for extremely symptomatic, recurrent AF which was resistant to antiarrhythmic drugs (1A, 1C, Sotalol, Amiodarone) used in combination. In 1 pt type I AF was present, in 6 pts type I and II AF was observed, in 1 pt the type was not identifiable. We delivered several RF impulses (10-25 W for 5-10 sec) to the area of slow conduction by means of the distal electrode of a 4-polar lead used in unipolar configuration. In 7 pts RF terminated AF within 24 hours after the procedure without any complication. During the follow-up (range 4-15 months), 6 pts had not AF recurrences; in 1 pt AF resumed 13 months later, in 1 pt stable atrial fibrillation developed, all of them were symptom-free. Three pts were on antiarrhythmic drugs (2 on Amiodarone for ventricular arrhythmias, 1 on Amiodarone and Sotalol for episodes of non sustained atrial fibrillation). We suggest that localized ablation of slow conduction area of the reentrant circuit may have a role in the treatment of drug-resistant AF without the need for nodal ablation and permanent pacemaker.
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M3 - Article
AN - SCOPUS:0026644854
VL - 8
SP - 481
EP - 486
JO - New Trends in Arrhythmias
JF - New Trends in Arrhythmias
SN - 0393-5302
IS - 1-2
ER -