Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy

F. Ambrosini, M. Arlotti, M. Landolina, R. Manfredini, P. Broglia, L. Sernesi, A. Lotto

Research output: Contribution to journalArticle

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 languageEnglish
Pages (from-to)481-486
Number of pages6
JournalNew Trends in Arrhythmias
Volume8
Issue number1-2
Publication statusPublished - 1992

Fingerprint

Atrial Flutter
Pharmaceutical Preparations
Amiodarone
Sotalol
Anti-Arrhythmia Agents
Atrial Fibrillation
Cardiac Arrhythmias
Heart Diseases
Electrodes
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Ambrosini, F., Arlotti, M., Landolina, M., Manfredini, R., Broglia, P., Sernesi, L., & Lotto, A. (1992). Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy. New Trends in Arrhythmias, 8(1-2), 481-486.

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 journalArticle

Ambrosini, F, Arlotti, M, Landolina, M, Manfredini, R, Broglia, P, Sernesi, L & Lotto, A 1992, 'Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy', New Trends in Arrhythmias, vol. 8, no. 1-2, pp. 481-486.
Ambrosini F, Arlotti M, Landolina M, Manfredini R, Broglia P, Sernesi L et al. Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy. New Trends in Arrhythmias. 1992;8(1-2):481-486.
Ambrosini, F. ; Arlotti, M. ; Landolina, M. ; Manfredini, R. ; Broglia, P. ; Sernesi, L. ; Lotto, A. / Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy. In: New Trends in Arrhythmias. 1992 ; Vol. 8, No. 1-2. pp. 481-486.
@article{347a2dcdcc9c4e4db5c09de65fae3e9f,
title = "Treatment and conversion of drug-resistant atrial flutter with radiofrequency energy",
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.",
author = "F. Ambrosini and M. Arlotti and M. Landolina and R. Manfredini and P. Broglia and L. Sernesi and A. Lotto",
year = "1992",
language = "English",
volume = "8",
pages = "481--486",
journal = "New Trends in Arrhythmias",
issn = "0393-5302",
number = "1-2",

}

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.

UR - http://www.scopus.com/inward/record.url?scp=0026644854&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026644854&partnerID=8YFLogxK

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 -