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SCHNEIDER HEIKEE, STAHL MAJA, KRIEBEL THOMAS, SCHILLINGER WOLFGANG, SCHILL MANFRED, JAKOBI JOHANNES, PAUL THOMAS. Double Cryoenergy Application (Freeze-Thaw-Freeze) at Growing Myocardium: Lesion Volume and Effects on Coronary Arteries Early After Energy Application. Implications for Efficacy and Safety in Pediatric Patients. J Cardiovasc Electrophysiol 2013; 24:701-7. [DOI: 10.1111/jce.12085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 12/19/2012] [Accepted: 12/21/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - MAJA STAHL
- Department for Pediatric Cardiology and Intensive Care Medicine
| | - THOMAS KRIEBEL
- Department for Pediatric Cardiology and Intensive Care Medicine
| | - WOLFGANG SCHILLINGER
- Department for Cardiology and Pneumology; Georg-August-University, Göttingen; Germany
| | - MANFRED SCHILL
- Department for Pediatric Cardiology and Intensive Care Medicine
| | - JOHANNES JAKOBI
- Department for Pediatric Cardiology and Intensive Care Medicine
| | - THOMAS PAUL
- Department for Pediatric Cardiology and Intensive Care Medicine
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Khairy P, Guerra PG, Rivard L, Tanguay JF, Landry E, Guertin MC, Macle L, Thibault B, Tardif JC, Talajic M, Roy D, Dubuc M. Enlargement of Catheter Ablation Lesions in Infant Hearts With Cryothermal Versus Radiofrequency Energy. Circ Arrhythm Electrophysiol 2011; 4:211-7. [DOI: 10.1161/circep.110.958082] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Paul Khairy
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Peter G. Guerra
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Lena Rivard
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Jean-François Tanguay
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Evelyn Landry
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Marie-Claude Guertin
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Laurent Macle
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Bernard Thibault
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Jean-Claude Tardif
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Mario Talajic
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Denis Roy
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
| | - Marc Dubuc
- From the Electrophysiology Service and Research Center, Montreal Heart Institute, and the Biostatistics Service, Montreal Heart Institute Coordinating Centre, Université de Montréal, Montreal, Canada
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Osborn DA, Lau KC, Uther JB, Coughtrey H, Rochefort MJ. Radiofrequency catheter ablation in a haemodynamically compromised premature neonate with hydrops fetalis. J Paediatr Child Health 1999; 35:406-8. [PMID: 10457304 DOI: 10.1046/j.1440-1754.1999.00367.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A preterm infant was born at 35 weeks gestation after failed antenatal antiarrhythmic therapy. The infant had an incessant supraventricular tachycardia, impaired ventricular function and hypotension and failed to respond to adenosine, cardioversion and intravenous amiodarone. After resuscitation from cardiovascular collapse, a successful radiofrequency catheter ablation (RFA) of a left free wall atrioventricular pathway was performed at 24 h of age without extracorporeal support. The infant is normal on follow up at 12 months of age. Whilst most fetal and neonatal supraventricular tachyarrhythmias respond to antiarrhythmic medications and RFA is not required, this is the earliest RFA to be performed on a premature infant when antiarrhythmics have failed.
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Affiliation(s)
- D A Osborn
- Neonatal Intensive Care Unit, Westmead Hospital, Westmead, Australia.
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Tanel RE, Walsh EP, Triedman JK, Epstein MR, Bergau DM, Saul JP. Five-year experience with radiofrequency catheter ablation: implications for management of arrhythmias in pediatric and young adult patients. J Pediatr 1997; 131:878-87. [PMID: 9427894 DOI: 10.1016/s0022-3476(97)70037-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE A review of the results of the first 5 years of radiofrequency catheter ablation procedures performed at Children's Hospital, Boston, a large tertiary referral center for patients with congenital heart disease and arrhythmias common to the infant, child, and young adult. STUDY DESIGN A retrospective review of 410 consecutive procedures in 346 patients who underwent at least one application of radiofrequency energy for the treatment of recurrent supraventricular or ventricular tachycardia. RESULTS The overall final success rate for all diagnoses was 90%, with a higher success rate in patients with an accessory pathway (96%). During the 5-year study period, the success rate improved while the rates of failures and late recurrences declined. The incidence of serious complications was 1.2% (1 late death, 1 ventricular dysfunction, 1 complete heart block, 1 cardiac perforation, and 1 cerebrovascular accident). CONCLUSIONS This report of a large series of radiofrequency catheter ablation procedures performed at an institution committed to treating congenital heart disease and pediatric arrhythmias confirms the safety and efficacy of this procedure. The pediatric cardiologist/electrophysiologist treating such patients must be aware of specific technical, anatomic, and electrophysiologic variations in the pediatric patient that are critical to the success of this therapy.
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Affiliation(s)
- R E Tanel
- Department of Cardiology, Children's Hospital, Boston, MA 02115, USA
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Vassilikos VP, Ho SY, Wong CY, Nathan AW. Recurrence of accessory pathway conduction after successful radiofrequency ablation: histological findings. J Interv Card Electrophysiol 1997; 1:311-5. [PMID: 9869986 DOI: 10.1023/a:1009737211189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The histological findings from a patient with Wolff-Parkinson-White syndrome (right superior paraseptal accessory pathway) who underwent successful radiofrequency ablation and had recurrence of tachycardia one month later in the absence of overt pre-excitation are reported. Histology revealed three small, oval to circular shaped, whitish, smooth areas on the right endocardial surface, the one being situated at the atrial free wall, and the other two being at the ventricular aspect. A very small hole was present in the interventricular component of the membranus septum. The accessory pathway band passed to either side of the small hole albeit disrupted by fibrous tissue in places. These findings indicate that multiple applications may cause penetration of the myocardium, and to achieve success, complete disruption of the pathway at some point along its course is required. Recurrence of retrograde accessory pathway conduction can be explained with the impedance mismatch hypothesis.
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Affiliation(s)
- V P Vassilikos
- Cardiology Department, St Bartholomew's Hospital, London, UK
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