Original Article
Diagnosis and Cure of the Wolff-Parkinson-White Syndrome or Paroxysmal Supraventricular Tachycardias during a Single Electrophysiologic Test
N Engl J Med 1991; 324:1612-1618June 6, 1991
- Abstract
- Abstract
Background.
We conducted this study to determine the feasibility of an abbreviated therapeutic approach to the Wolff-Parkinson-White syndrome or paroxysmal supraventricular tachycardia, in which the diagnosis is established and radiofrequency ablation carried out during a single electrophysiologic test.
Methods.
One hundred six consecutive patients were referred for the management of documented, symptomatic paroxysmal supraventricular tachycardias (66 patients) or the Wolff—Parkinson—White syndrome (40 patients). All agreed to undergo a diagnostic electrophysiologic test and catheter ablation with radiofrequency current. No patient had had such a test previously.
Results.
Among the 66 patients with paroxysmal supraventricular tachycardias, the mechanism was found to be atrioventricular nodal reentry in 46 (70 percent) (typical in 44 and atypical in 2), atrioventricular reciprocating tachycardia involving a concealed accessory pathway in 16 (24 percent), atrial tachycardia in 2 (3 percent), and noninducible paroxysmal supraventricular tachycardia in 2 (3 percent). A successful long-term outcome was achieved in 57 of 62 patients (92 percent) with paroxysmal supraventricular tachycardia in whom ablation was attempted and in 37 of 40 patients (93 percent) with the Wolff—Parkinson—White syndrome. The only complications were one instance of occlusion of the left circumflex coronary artery, leading to acute myocardial infarction, and one instance of complete atrioventricular block. The mean (±SD) duration of the electrophysiologic procedures was 114±55 minutes.
Conclusions.
The diagnosis and cure of paroxysmal supraventricular tachycardia or the Wolff—Parkinson—White syndrome during a single electrophysiologic test are feasible and practical and have a favorable risk-benefit ratio. This abbreviated therapeutic approach may eliminate the need for serial electropharmacologic testing, long-term drug therapy, antitachycardia pacemakers, and surgical ablation. (N Engl J Med 1991; 324:1612–8.)
Media in This Article
Figure 1
Presumed Accessory-Pathway Potential Recorded in a Patient Who Had a Posteroseptal Accessory Pathway.Figure 2
Typical Atrioventricular Nodal Reentrant Tachycardia, Eliminated by Radiofrequency Current.Article Activity
- Article
THE therapeutic options in patients with the Wolff—Parkinson—White syndrome or other paroxysmal supraventricular tachycardias have included antiarrhythmic-drug therapy on an empirical basis or as guided by electropharmacologic testing,1 2 3 antitachycardia pacemakers,4 , 5 curative surgical procedures,6 7 8 9 10 and catheter ablation of the atrioventricular junction followed by the implantation of a permanent pacemaker.11 Recently, catheter ablation techniques have been developed to treat atrioventricular nodal reentrant tachycardia (the most common type of paroxysmal supraventricular tachycardia) and the Wolff—Parkinson—White syndrome. Direct-current countershocks or radiofrequency current delivered through an electrode catheter has been used either to eliminate atrioventricular nodal reentry without interrupting atrioventricular conduction12 13 14 or to ablate accessory pathways.15 16 17 18 19
The purpose of this study was to determine the feasibility of an abbreviated approach to the treatment of patients with paroxysmal supraventricular tachycardias or the Wolff—Parkinson—White syndrome, aimed at combining a diagnostic and therapeutic procedure into a single electrophysiologic test. Radiofrequency current was used to eliminate atrioventricular nodal reentrant tachycardia or to ablate accessory pathways in patients undergoing their first electrophysiologic test.
Methods
Characteristics of Patients
The subjects of this study were 106 consecutive patients referred to the University of Michigan Medical Center between February and November 1990: 66 for management of documented, symptomatic paroxysmal supraventricular tachycardias of undetermined mechanism and 40 for management of the Wolff—Parkinson—White syndrome. No patient had had a previous electrophysiologic test. Each patient with paroxysmal supraventricular tachycardia was documented to have had a regular, narrow QRS-complex tachycardia either in an emergency room or during electrocardiographic monitoring, and each patient with the Wolff—Parkinson—White syndrome had a history of symptomatic tachycardia and electrocardiographic evidence of ventricular preexcitation.
There were 49 male and 57 female patients, and their mean (±SD) age was 43±18 years (range, 15 to 79). Eight patients had coronary artery disease, one had Ebstein's anomaly, and one had mild aortic stenosis. Ninety-six patients had no evidence of structural heart disease.
The patients had had their first episode of symptomatic paroxysmal supraventricular tachycardia a mean of 14±10 years before referral. Fifty-three patients estimated that they had had more than 50 episodes of paroxysmal supraventricular tachycardia; the remaining 53 patients estimated that they had had 4 to 45 episodes (mean, 18±10). A mean of 2.5±1.5 antiarrhythmic drugs (range, 0 to 6) either had been ineffective or had not been tolerated before referral.
Electrophysiologic Testing
Informed consent was obtained from all patients under an investigational protocol approved by the Human Research Committee at the University of Michigan. Electrophysiologic tests were performed while the patients were fasting. All antiarrhythmic medications were discontinued at least 24 hours before the procedure. All patients were in sinus rhythm and were hemodynamically stable at the beginning of the procedure. Three 6-French quadripolar electrode catheters (USCI, Billerica, Mass.) were inserted into a femoral vein and positioned in the right atrium, across the tricuspid valve to record the His-bundle electrogram, and in the right ventricle. If initial testing indicated that the paroxysmal supraventricular tachycardia was not caused by typical atrioventricular nodal reentry or if the electrocardiogram demonstrated preexcitation, an additional quadripolar electrode catheter was inserted into an internal jugular or subclavian vein and positioned in the coronary sinus. The tracings from electrocardiographic Leads V1, I, and II or III and the intracardiac electrograms were displayed on an oscilloscope and recorded on a Mingograf 7 recorder (Siemens-Elema, Solna, Sweden) at a paper speed of 100 to 200 mm per second. Pacing was performed with a programmable stimulator (Bloom Associates, Reading, Pa.) with the use of stimuli lasting 2 msec and a current strength twice the late diastolic threshold. A 3000-unit bolus of heparin was infused after the catheters had been positioned. In patients with a left-sided accessory pathway, an additional 3000-unit bolus followed by a 1000-unit bolus every hour was administered after the insertion of a catheter in the left ventricle.
The diagnostic portion of the electrophysiologic test was aimed at measuring the conduction properties and refractory periods of the atrioventricular node and an accessory pathway, if present, and inducing paroxysmal supraventricular tachycardia and determining its mechanism. The cycle lengths at which atrioventricular or ventriculoatrial block developed were measured by incremental atrial and ventricular pacing in steps of 10 msec. Refractory periods were determined by scanning diastole in steps of 10 msec with an atrial or ventricular extrastimulus inserted after eight-beat basic drive trains that had a cycle length of 400 to 600 msec. If paroxysmal supraventricular tachycardia was not induced by these maneuvers, programmed stimulation was performed with two atrial or ventricular extrastimuli. Pacing was repeated during an infusion of isoproterenol at a rate of 1 to 2 μg per minute or after the intravenous administration of 1 to 2 mg of atropine if paroxysmal supraventricular tachycardia could not be induced in the base-line state. Induced tachycardias were classified as atrioventricular nodal reentrant (typical or atypical), atrioventricular reciprocating tachycardia involving a concealed accessory pathway, or atrial on the basis of criteria that have been described previously.20
Catheter Ablation Techniques
Radiofrequency current at a frequency of 350 kHz was delivered as a continuous, unmodulated sine-wave output from an electrosurgical unit (model RFG-3B, Radionics, Burlington, Mass.). The radiofrequency current was delivered through either a 6-French bipolar catheter with an electrode whose tip measured 3 mm and an interelectrode spacing of 2 mm (USCI) or a 7-French quadripolar catheter with an electrode with a 4-mm tip, an interelectrode spacing of 5 mm, and a deflectable curve (Mansfield—Webster, Watertown, Mass.). Radiofrequency current was delivered between the tip electrode and an indifferent patch electrode (Valleylab, Boulder, Colo.) positioned on the chest.
The technique used to eliminate atrioventricular nodal reentrant tachycardia has been described previously.14 Ten to 20 W of radiofrequency current was delivered for 15 to 60 seconds to sites on the lower part of the right atrial septum that had the following electrographic characteristics during sinus rhythm: an atrial electrogram of more than 0.5 mV, a His-bundle potential of less than 0.04 mV, and an atrial:ventricular electrogram ratio of more than 1.0. The end points of the procedure were an increase of 50 to 100 percent in the atrial—His bundle interval, elimination or marked slowing of ventriculoatrial conduction, and an inability to induce paroxysmal supraventricular tachycardia before and during the infusion of 2 μg of isoproterenol per minute.
In patients who had the Wolff—Parkinson—White syndrome or paroxysmal supraventricular tachycardias associated with an accessory pathway, a 7-French catheter with a 4-mm tip was used for precise localization of the accessory pathway and delivery of radio-frequency current. Left-sided accessory pathways were approached from the ventricular aspect of the mitral annulus. The ablation catheter was inserted into the femoral artery and passed in retrograde fashion across the aortic valve into the left ventricle. In patients with a right-sided or posteroseptal accessory pathway, the ablation catheter was inserted into the femoral vein and passed into the right atrium through the inferior vena cava. For ablation of right-sided pathways, the catheter was positioned on the atrial aspect of the tricuspid valve, and for ablation of posteroseptal accessory pathways, the catheter was positioned in the vicinity of the ostium of the coronary sinus. Accessory pathways that were capable of anterograde conduction were mapped primarily during sinus rhythm or atrial pacing. Target sites for ablation were identified by one or more of the following: discrete atrial and ventricular electrograms, early ventricular activation relative to the onset of the delta wave, and a discrete potential preceding the local ventricular electrogram suggestive of an accessory-pathway potential (Fig. 1Figure 1
Presumed Accessory-Pathway Potential Recorded in a Patient Who Had a Posteroseptal Accessory Pathway. ). Concealed accessory pathways were mapped during atrioventricular reciprocating tachycardia or ventricular pacing. Sites suitable for ablation were identified by one or more of the following: discrete atrial and ventricular electrograms, early atrial activation, and a presumed accessory-pathway potential.Once a site suitable for catheter ablation was identified, 25 to 36 W of radiofrequency current was delivered for 10 to 20 seconds. Whenever the application of radiofrequency current at a given site eliminated conduction through the accessory pathway, a second application was delivered before the catheter was removed. In each patient, the time required for inserting and positioning the catheters, for the diagnostic component of the electrophysiologic test, and for the catheter ablation procedure was recorded. The time required to remove the catheters and to achieve hemostasis was not recorded. The duration of the procedures was limited to four hours.
Monitoring and Evaluation after Ablation
After the procedure, patients underwent continuous electrocardiographic monitoring on an inpatient basis for two days. The creatine kinase MB fraction was measured every 8 hours for 24 hours, and a 12-lead electrocardiogram was obtained daily. All patients who did not have preexcitation before ablation had a follow-up electrophysiologic test two days after the procedure. If paroxysmal supraventricular tachycardia was inducible, additional applications of radiofrequency current were delivered. If paroxysmal supraventricular tachycardia could not be induced, the patient was sent home three hours after the electrophysiologic test. To assess the long-term results of the ablation procedure, the patients had a final follow-up electrophysiologic test three months later.
Catheter ablation was judged to be successful if there was no evidence of an accessory pathway and no inducible paroxysmal supraventricular tachycardias before and during an infusion of isoproterenol at the three-month follow-up electrophysiologic test and if the patient remained free of spontaneous recurrences of symptomatic tachycardia in the absence of antiarrhythmic-drug therapy. All patients were followed for a minimum of three months. Outcome was judged solely on a clinical basis in eight patients with paroxysmal supraventricular tachycardias and three patients with the Wolff—Parkinson—White syndrome who declined to have the three-month follow-up electrophysiologic test.
Statistical Analysis
Continuous variables are expressed as means ± 1 SD. Comparisons were performed with Student's t-test or by chi-square analysis. A P value of less than 0.05 was considered to indicate statistical significance.
Results
Base-Line Findings
Among the 66 patients with paroxysmal supraventricular tachycardias, 46 (70 percent) were found to have atrioventricular nodal reentrant tachycardia (typical in 44 patients and atypical in 2), 16 (24 percent) had atrioventricular reciprocating tachycardia involving a concealed accessory pathway (located in the left free wall in 14 and posteroseptally in 2 patients), 2 (3 percent) had an atrial tachycardia, and 2 (3 percent) had noninducible paroxysmal supraventricular tachycardia. Radiofrequency ablation was attempted in the 62 patients who had atrioventricular nodal reentrant tachycardia or atrioventricular reciprocating tachycardia. The four patients who had an atrial tachycardia or noninducible paroxysmal supraventricular tachycardia were treated with propafenone or atenolol.
Each of the 40 patients with the Wolff—Parkinson—White syndrome was found to have a single accessory pathway. Twenty-seven were left-sided, eight were posteroseptal, three were right-sided, and two were midseptal. The mean cycle length at which anterograde block developed in the accessory pathways was 296±80 msec, and the mean cycle length at which retrograde block developed was 282 ±76 msec.
Overall Results
The radiofrequency ablation procedure was effective on a long-term basis in 57 of the 62 patients (92 percent) with paroxysmal supraventricular tachycardias and in 37 of the 40 patients (93 percent) with the Wolff—Parkinson—White syndrome The procedure was ineffective in two patients with typical atrioventricular nodal reentrant tachycardia, two patients with atypical atrioventricular nodal reentrant tachycardia, one patient with atrioventricular reciprocating tachycardia involving a concealed accessory pathway, and three patients with the Wolff—Parkinson—White syndrome.
The mean duration of the electrophysiologic tests was 114±55 minutes. A mean of 35±12 minutes was required to insert and position the catheters, 21—10 minutes for the diagnostic component, and 58—52 minutes for the therapeutic component.
Therapy of Paroxysmal Supraventricular Tachycardia
A successful outcome was achieved in 42 of the 44 patients (95 percent) who had typical atrioventricular nodal reentrant tachycardia (Fig. 2Figure 2
Typical Atrioventricular Nodal Reentrant Tachycardia, Eliminated by Radiofrequency Current.). A mean of 6±4 applications of radiofrequency current were used. A single session of radiofrequency ablation was sufficient to achieve a successful outcome in 37 of the 44 patients (84 percent), whereas a second session was required in 5 patients (11 percent) who had a recurrence of paroxysmal supraventricular tachycardia two days to two months after the initial procedure. forty-two patients remained free of symptomatic paroxysmal supraventricular tachycardia after a mean follow-up of 9±2 months. In addition, an electrophysiologic test performed in 37 of the 42 patients three months after the last ablation session demonstrated the absence of inducible paroxysmal supraventricular tachycardias in each patient.The long-term electrophysiologic effects of radiofrequency ablation on atrioventricular conduction in the 37 patients with a successful clinical outcome who had a three-month follow-up electrophysiologic test are summarized in Table 1Table 1
Long-Term Electrophysiologic Effects of Radiofrequency Ablation of Atrioventricular Nodal Reentrant Tachycardia in 37 Patients with Successful Long-Term Outcomes Who Had a Three-Month Follow-up Electrophysiologic Test.*. The mean sinus-cycle length, His bundle—ventricular interval, and cycle length at which atrioventricular block developed, measured three months after the ablation procedure, did not differ significantly from the base-line values. There was nearly a twofold increase in the atrial—His bundle interval (P<0.001). Dual atrioventricular nodal pathways were demonstrated with the atrial-extrastimulus technique in 31 of 37 patients (84 percent) at base line but were not found in any patient three months after ablation (P<0.001). None of the patients had ventriculoatrial dissociation at base line, whereas it was present in 24 of 37 patients (65 percent) three months after ablation (P<0.001).A successful clinical outcome was achieved with one session of ablation in 14 of the 16 patients with paroxysmal supraventricular tachycardia determined to be atrioventricular reciprocating tachycardia involving a concealed accessory pathway and with two sessions in a patient who had a recurrence of tachycardia two months after the first session. The mean number of applications of radiofrequency current in this group was 5±6. The outcome was unsuccessful in one patient after two attempts; his left anterolateral accessory pathway was successfully ablated at another facility one month later.
Treatment of the Wolff—Parkinson—White Syndrome
Among the 40 patients with the Wolff—Parkinson—White syndrome, 37 (93 percent) had successful outcomes during a mean follow-up of 6±2 months (Fig. 3Figure 3
Ablation of a Right-Sided Accessory Pathway in a Patient with the Wolff—Parkinson—White Syndrome.). Thirty-three patients with successful outcomes had a single session of ablation. Four patients required a second session because the first attempt was unsuccessful. The mean number of applications of radiofrequency current during successful ablation sessions was 7±6. The mean number of applications of radiofrequency energy in the three patients with unsuccessful outcomes was 16±10. The accessory pathways that were not ablated were located in the left lateral region in two patients and the midseptal region in one patient. One of these patients subsequently underwent surgical ablation, and two patients have been treated with antiarrhythmic drugs.Complications
A complication occurred in 2 of 102 patients in whom catheter ablation was attempted. One patient who had atrioventricular reciprocating tachycardia with a concealed accessory pathway in the left free wall had chest pain and electrocardiographic evidence of lateral myocardial infarction immediately after an application of radiofrequency current on what was thought to be the left ventricular side of the mitral annulus. Coronary angiography 30 minutes later showed complete occlusion of the left circumflex coronary artery, a blockage that was immediately reversed by angioplasty. There was no evidence of conduction through the accessory pathway after the angioplasty. Comparison of the coronary angiogram with the fluoroscopic position of the ablation catheter suggested that the catheter inadvertently had been positioned in the left coronary artery. The patient sustained a myocardial infarction and had a peak creatine kinase concentration of 3566 IU per liter (normal, 20 to 180) and a peak concentration of the creatine kinase MB fraction of 228 IU per liter (normal, 0 to 10). Radionuclide angiography one week later showed a left ventricular ejection fraction of 0.55. There have been no recurrences of paroxysmal supraventricular tachycardia during 10 months of follow-up. Three other patients who underwent ablation of accessory pathways had a rise in the creatine kinase MB fraction (mean, 18±13 IU per liter; range, 11 to 60) after the procedure, but none had electrocardiographic changes suggestive of infarction. Echocardiography did not reveal any evidence of pericardial effusion, mitral-valve or tricuspid-valve dysfunction, or wall-motion abnormalities attributable to radiofrequency ablation.
One patient had persistent complete atrioventricular nodal block one day after an attempt at radiofrequency ablation of typical atrioventricular nodal reentrant tachycardia and subsequently had a permanent pacemaker implanted. Transient Mobitz I or third-degree atrioventricular nodal block lasting 1 to 24 hours occurred in four additional patients who underwent radiofrequency ablation aimed at eliminating atrioventricular nodal reentrant tachycardia. These patients all had intact atrioventricular conduction at the three-month follow-up electrophysiologic test.
Discussion
The results of this study indicate the diagnosis and cure of paroxysmal supraventricular tachycardias or the Wolff—Parkinson—White syndrome during a single electrophysiologic test are feasible in a majority of patients. More than 90 percent of the patients referred for management of paroxysmal supraventricular tachycardia in this study were found to have atrioventricular nodal reentrant or atrioventricular reciprocating tachycardia, both of which were amenable to ablation with radiofrequency current. Among the 62 patients who had one of these two types of paroxysmal supraventricular tachycardia and the 40 patients with the Wolff—Parkinson—White syndrome, successful long-term ablation of the tachycardia or accessory pathway was achieved in 82 percent of patients with a single session of ablation during the initial electrophysiologic test. In an additional 10 percent of patients, a successful long-term outcome also was achieved, but a second session of ablation was required. The attempts at catheter ablation resulted in a complication in only 2 of 102 patients (2 percent). The mean duration of the electrophysiologic procedures was less than 2 hours, and the majority of patients were hospitalized for only 48 to 54 hours. Therefore, our results demonstrate that an abbreviated approach to the management of paroxysmal supraventricular tachycardias and the Wolff—Parkinson—White syndrome that is aimed at diagnosis and cure during a single electrophysiologic test is practical and has a low risk of complications in the majority of cases.
The most common mechanism of paroxysmal supraventricular tachycardia has been reported to be atrioventricular nodal reentrant tachycardia,21 as was the case in this study. In the typical form of atrioventricular nodal reentrant tachycardia, a slowly conducting pathway within or adjacent to the atrioventricular node serves as the anterograde limb of the reentry circuit, and a rapidly conducting pathway serves as the retrograde limb. The catheter ablation technique used in this study was highly effective in eliminating this type of tachycardia, with a successful long-term outcome in 42 of 44 patients (95 percent). Radiofrequency ablation in these patients was associated with a nearly twofold increase in the atrial—His bundle interval, elimination or marked slowing of ventriculoatrial conduction, and loss of evidence of dual atrioventricular nodal pathways. These changes suggest that the tachycardia was eliminated by inducing blockage or marked slowing in the rapidly conducting pathway.
In the atypical form of atrioventricular nodal reentrant tachycardia, the rapidly conducting pathway serves as the anterograde limb of the reentry circuit.21 The ablation procedure was ineffective in both patients in this study who had atypical atrioventricular nodal reentrant tachycardia. Nevertheless, because typical atrioventricular nodal reentrant tachycardia is many times more prevalent than the atypical form, the catheter ablation technique described in this study is suitable for the vast majority of patients who have atrioventricular nodal reentrant tachycardia.
Radiofrequency catheter ablation of accessory pathways has been described previously in isolated case reports and preliminary reports.18 , 19 , 22 23 24 Jackman et al. reported a success rate of 100 percent in a preliminary study of 44 patients who underwent radiofrequency catheter ablation of left-sided accessory pathways.18 Our success rate of 93 percent compares favorably with the results of Jackman et al. given the abbreviated approach used in our study. Our results also compare favorably with previous reports of catheter ablation using direct-current shocks. Several investigators have reported success rates of 50 to 70 percent for ablation of posteroseptal accessory pathways.16 , 25 Warin et al. reported complete ablation of 236 of 254 accessory pathways in all locations with direct-current shocks.17 Whereas approximately 30 percent of their patients required two or more sessions of ablation because of the return of conduction through the accessory pathway within one week after the initial attempt,16 a second session was needed because of the recurrence of conduction through the accessory pathway in only one patient in this study. This suggests that the tissue effects of radiofrequency current may be less frequently reversible than the effects of direct-current shocks.
To minimize patient discomfort and maximize the feasibility of performing a single electrophysiologic test to diagnose and cure paroxysmal supraventricular tachycardia or the Wolff—Parkinson—White syndrome in clinical practice, an effort was made to shorten the length of the electrophysiologic tests as much as possible. As a result, the mean duration of the procedures in this study was less than two hours.
A number of factors contributed to the relatively brief duration of the electrophysiologic tests. First, central venous access was obtained through an internal jugular or subclavian vein and an electrode catheter was positioned in the coronary sinus only if initial testing with three electrode catheters inserted through a femoral vein indicated that the paroxysmal supraventricular tachycardia was not typical atrioventricular nodal reentrant tachycardia. Second, in patients with atrioventricular nodal reentrant tachycardia, sites for the delivery of radiofrequency current were selected during sinus rhythm, and detailed mapping of the atrial activation sequence during tachycardia was not necessary. Third, during the diagnostic portion of the electrophysiologic test, the accessory pathways were localized to a general region of the heart, and precise localization was performed only with the ablation catheter itself. Fourth, because the applications of radiofrequency current were associated with either no discomfort or only mild discomfort, the induction of general anesthesia was not necessary. Fifth, the length of the electrophysiologic tests was limited to four hours; although a longer duration may have resulted in a successful outcome in a higher percentage of patients, procedures longer than four hours often are not feasible in clinical practice. Finally, because both the duration and efficacy of catheter ablation procedures are operator-dependent, the present study was initiated only after several weeks to months of preliminary experience with the ablation techniques described herein. Although a four-hour limit was used in this study, patients with multiple accessory pathways may require a somewhat longer procedure for mapping and ablation.
A clinically important complication occurred in 2 of the 102 patients (2 percent) in whom an ablation procedure was attempted. It is likely that the one instance of thrombotic occlusion of the proximal left circumflex coronary artery could have been avoided by more careful attention to the position of the ablation catheter. Injury to or occlusion of the coronary artery was never observed in other studies that employed either radiofrequency current or direct-current countershocks to ablate accessory pathways.15 16 17 18 , 22 , 23 Although the risk of acute injury or occlusion of a coronary artery as a result of catheter ablation of accessory pathways appears to be very low, several years of follow-up will be needed to rule out long-term complications.
Persistent complete atrioventricular nodal block developed in one patient with atrioventricular nodal reentry and required the insertion of a pacemaker. Other studies in which direct-current shocks or radio-frequency current have been used to eliminate atrioventricular nodal reentry tachycardia have reported an 8 to 10 percent incidence of persistent third-degree atrioventricular nodal block.12 , 14 Therefore, catheter ablation of atrioventricular nodal reentrant tachycardia with the use of techniques similar to the one used in this study clearly is associated with a risk of atrioventricular block and the possibility that a permanent pacemaker might be necessary. In patients with paroxysmal supraventricular tachycardias who have had severe symptoms and who have not responded well to pharmacologic therapy, the small risk that a permanent pacemaker may be needed may be acceptable. On the other hand, even a risk as low as 2 percent may not be justified in patients who have had only mild symptoms or whose paroxysmal supraventricular tachycardias have been well controlled by empirical antiarrhythmic-drug therapy.
An abbreviated therapeutic approach to paroxysmal supraventricular tachycardias unresponsive to empirical drug therapy and the Wolff—Parkinson—White syndrome has clear-cut advantages over the other available treatment strategies. This one-step approach should be considered in patients with the Wolff—Parkinson—White syndrome and patients with paroxysmal supraventricular tachycardias who have not responded to antiarrhythmic-drug therapy. In a majority of patients, this approach eliminates the need for serial electropharmacologic testing; the inconvenience, expense, and side effects of long-term drug therapy; and the potential morbidity, discomfort, and expense of open-heart surgery, with its attendant lengthy recovery. In patients with paroxysmal supraventricular tachycardias, this approach can also often eliminate the need for antitachycardia pacemakers and catheter ablation of the atrioventricular junction. Each of these forms of therapy requires an initial electrophysiologic test followed by some other form of therapy. In contrast, the abbreviated approach condenses the entire treatment process into a single procedure. Although the same result could be achieved with a staged approach of diagnosis followed by catheter ablation of the tachycardia or accessory pathway during a second procedure, the results of this study demonstrate that the inconvenience and additional expense of a staged approach are not necessary. However, it should be emphasized that the abbreviated approach to therapy described in this study may be appropriate only in electrophysiologic laboratories with teams of highly experienced operators.
Dr. Langberg serves as a consultant for EP Technologies, a company that manufactures electrode catheters that can be used for ablation.
We are indebted to Dr. Warren Jackman for introducing us to his technique for accessory-pathway ablation, to Dr. Narsingh Gupta for referring several of the patients in this study, to the staff of the Clinical Electrophysiology Laboratory for their technical support, and to Marion Maguire for her assistance in the preparation of the manuscript.
Source Information
From the Department of Internal Medicine, Division of Cardiology, University of Michigan Medical Center, Ann Arbor. Address reprint requests to Dr. Morady at the University of Michigan Medical Center, 1500 E. Medical Center Dr., B1 F245, Ann Arbor, MI 48109–0022.
- References
References
1
Wu
Web of Science | Medline2
Bauernfeind
Web of Science | Medline3
Waldo
CrossRef | Web of Science | Medline4
Griffin
CrossRef | Web of Science | Medline5
den Dulk
CrossRef6
Ross
CrossRef | Web of Science | Medline7
Cox
CrossRef | Web of Science | Medline8
Fujimura
CrossRef | Web of Science | Medline9
Cox
CrossRef | Web of Science | Medline10
Guiraudon
CrossRef | Web of Science | Medline11
Scheinman
CrossRef | Web of Science | Medline12
Haissaguerre
Full Text | Web of Science | Medline13
Epstein
CrossRef | Web of Science | Medline14
Lee
Web of Science | Medline15
Morady
CrossRef | Web of Science | Medline16
Warin
CrossRef | Web of Science | Medline17
Warin
CrossRef18
Jackman
Web of Science19
Kuck
CrossRef20
Leitch
Medline21
Josephson
Medline22
Roman 23
Kuck 24
Borggrefe
CrossRef | Web of Science | Medline25
Bardy
CrossRef | Web of Science | Medline
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J. P. Joseph, K. Rajappan. (2011) Radiofrequency ablation of cardiac arrhythmias: past, present and future. QJM
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FRANCISCO G. COSÍO. (2011) Learning by Burning in Atrial Fibrillation: An Uncertain, Complicated Quest. Journal of Cardiovascular Electrophysiology 22:5, 513-515
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Dipen Shah. (2011) A critical appraisal of cardiac ablation technology for catheter-based treatment of atrial fibrillation. Expert Review of Medical Devices 8:1, 49-55
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Elizabeth A. Stephenson, Andrew M. Davis. 2010. Electrophysiology, Pacing, and Devices. , 379-413.
CrossRef13
DAVID KEANE, BRIAN HYNES, ROBERT LAMKIN, CHRISTOPHER HOUGHTALING, LI ZHOU, THOMAS ARETZ, JEREMY RUSKIN. (2009) Linear Radiofrequency Microcatheter Ablation Guided by Phased Array Intracardiac Echocardiography Combined with Temperature Decay. Pacing and Clinical Electrophysiology 32:12, 1543-1552
CrossRef14
Rahul Sakhuja, Lisa M. Smith, Zian H. Tseng, Nitish Badhwar, Byron K. Lee, Randall J. Lee, Melvin M. Scheinman, Jeffrey E. Olgin, Gregory M. Marcus. (2009) Test Characteristics of Neck Fullness and Witnessed Neck Pulsations in the Diagnosis of Typical AV Nodal Reentrant Tachycardia. Clinical Cardiology 32:8, E13-E18
CrossRef15
Mahmoud Suleiman, Brian D. Powell, Thomas M. Munger, Samuel J. Asirvatham. (2008) Successful cryoablation in the noncoronary aortic cusp for a left anteroseptal accessory pathway. Journal of Interventional Cardiac Electrophysiology 23:3, 205-211
CrossRef16
Ilyes Kharrat, Hanene Charfeddine, Mohamed Sahnoun, Sofiene Rekik, Salma Krichen, Mourad Hentati, Samir Kammoun. (2008) Left main coronary thrombosis: unusual complication after radiofrequency ablation of left accessory atrioventricular pathway. Journal of Electrocardiology 41:6, 683-685
CrossRef17
Ken W. Lee, Nitish Badhwar, Melvin M. Scheinman. (2008) Supraventricular Tachycardia—Part I. Current Problems in Cardiology 33:9, 467-546
CrossRef18
Majid Haghjoo, Ali Kharazi, Amir Farjam Fazelifar, Abolfath Alizadeh, Zahra Emkanjoo, Mohammad Ali Sadr-Ameli. (2007) Electrocardiographic and electrophysiologic characteristics of anteroseptal, midseptal, and posteroseptal accessory pathways. Heart Rhythm 4:11, 1411-1419
CrossRef19
Karl-Heinz Kuck, Sabine Ernst, Uwe Dorwarth, Ellen Hoffmann, Heinz Pitschner, Jürgen Tebbenjohanns, Hans Kottkamp. (2007) Leitlinien zur Katheterablation. Clinical Research in Cardiology 96:11, 833-849
CrossRef20
Gilles E. O’Hara, François Philippon, Jean Champagne, Louis Blier, Franck Molin, Jean-Marc Côté, Isabelle Nault, Jean-François Sarrazin, Marcel Gilbert. (2007) Catheter ablation for cardiac arrhythmias: A 14-year experience with 5330 consecutive patients at the Quebec Heart Institute, Laval Hospital. Canadian Journal of Cardiology 23, 67B-70B
CrossRef21
KOONLAWEE NADEMANEE. (2007) Percutaneous Epicardial Catheter Ablation Opens Another Chapter in the Catheter-Based Ablation for Atrial Fibrillation. Journal of Cardiovascular Electrophysiology 18:9, 924-925
CrossRef22
Akira Fujiki, Kazuo Usuda, Koichi Mizumaki, Tsuyoshi Abe, Jotaro Iwamoto, Tadao Ishikawa, Hiroshi Inoue. (2007) Double potentials at successful catheter ablation site of left-sided retrograde accessory pathway: Mitral isthmus block or conduction through coronary sinus musculature. International Journal of Cardiology 117:1, 90-96
CrossRef23
Daniele D’Este, Franco Zoppo, Emanuele Bertaglia, Francesca Zerbo, Amedeo Picciolo, Virginia Scarabeo, Andrea Pascotto, Pietro Pascotto. (2007) Long-term outcome of patients with atrioventricular node reentrant tachycardia. International Journal of Cardiology 115:3, 350-353
CrossRef24
Delacrétaz, Etienne, . (2006) Supraventricular Tachycardia. New England Journal of Medicine 354:10, 1039-1051
Full Text25
Hiroshi Tada, Shigeto Naito, Shigeru Oshima, Koichi Taniguchi. (2005) Vasospastic angina shortly after left atrial catheter ablation for atrial fibrillation. Heart Rhythm 2:8, 867-870
CrossRef26
Sedat Kose, Basri Amasyali, Kudret Aytemir, Ilknur Can, Ayhan Kilic, Hurkan Kursaklioglu, Atila Iyisoy, Ersoy Isik. (2005) Radiofrequency catheter ablation of accessory pathways during pre-excited atrial fibrillation: acute success rate and long-term clinical follow-up results as compared to those patients undergoing successful catheter ablation during sinus rhythm. Heart and Vessels 20:4, 142-146
CrossRef27
MELVIN M. SCHEINMAN. (2005) History of Wolff-Parkinson-White Syndrome. Pacing and Clinical Electrophysiology 28:2, 152-156
CrossRef28
SVEN REEK, J. CHRISTOPH GELLER, HANS-ULRICH SCHILDHAUS, KENNETH L. RIPLEY, HELMUT U. KLEIN. (2004) Feasibility of Catheter Cryoablation in Normal Ventricular Myocardium and Healed Myocardial Infarction. Pacing and Clinical Electrophysiology 27:11, 1530-1539
CrossRef29
Miguel Valderrábano, David A. Cesario, Sen Ji, Kevin Shannon, Isaac Wiener, Charles D. Swerdlow, Hakan Oral, Fred Morady, Kalyanam Shivkumar. (2004) Percutaneous epicardial mapping during ablation of difficult accessory pathways as an alternative to cardiac surgery. Heart Rhythm 1:3, 311-316
CrossRef30
Philippe Chetaille, Edward P. Walsh, John K. Triedman. (2004) Outcomes of radiofrequency catheter ablation of atrioventricular reciprocating tachycardia in patients with congenital heart disease. Heart Rhythm 1:2, 168-173
CrossRef31
Peter L. Friedman, Marc Dubuc, Martin S. Green, Warren M. Jackman, David T.J. Keane, Roger A. Marinchak, Jose Nazari, Douglas L. Packer, Allan Skanes, Jonathan S. Steinberg, William G. Stevenson, Patrick J. Tchou, David J. Wilber, Seth J. Worley. (2004) Catheter cryoablation of supraventricular tachycardia: results of the multicenter prospective “frosty” trial. Heart Rhythm 1:2, 129-138
CrossRef32
GUILHERME FENELON, MARCELLO FRANCO, OSWALDO MORA, EDUARDO KATCHBURIAN, ANGELO A. V. de PAOLA. (2004) Combined Therapy with Steroids and Antioxidants Prevents Ultrastructural Damage Surrounding Chronic Radiofrequency Lesions. Pacing and Clinical Electrophysiology 27:1, 65-72
CrossRef33
Mamoru Manita, Yoshiaki Kaneko, Masahiko Kurabayashi, San-Jou Yeh, Ming-Shien Wen, Chun-Chieh Wang, Fun-Chung Lin, Delon Wu. (2004) Electrophysiological Characteristics and Radiofrequency Ablation of Accessory Pathways With Slow Conductive Properties. Circulation Journal 68:12, 1152-1159
CrossRef34
Kaoru Okishige, Tomoo Harada, Mihoko Kawabata, Kei Yamashiro, Ryouji Kishi, Kiyoshi Nakazawa, Fumihiko Miake, Mitsuaki Isobe. (2004) Transvenous Catheter Cryoablation of the Atrioventricular Node and Visual Assessment of Freezing of Cardiac Tissue Using Intracardiac Echocardiography. Japanese Heart Journal 45:3, 513-520
CrossRef35
Raymond J. Leveillee, Michael F. Hoey. (2003) Radiofrequency Interstitial Tissue Ablation: Wet Electrode. Journal of Endourology 17:8, 563-577
CrossRef36
Carina Blomström-Lundqvist, Melvin M Scheinman, Etienne M Aliot, Joseph S Alpert, Hugh Calkins, A.John Camm, W.Barton Campbell, David E Haines, Karl H Kuck, Bruce B Lerman, D.Douglas Miller, Charlie Willard Shaeffer, William G Stevenson, Gordon F Tomaselli, Elliott M Antman, Sidney C Smith, Joseph S Alpert, David P Faxon, Valentin Fuster, Raymond J Gibbons, Gabriel Gregoratos, Loren F Hiratzka, Sharon Ann Hunt, Alice K Jacobs, Richard O Russell, Silvia G Priori, Jean-Jacques Blanc, Andzrej Budaj, Enrique Fernandez Burgos, Martin Cowie, Jaap Willem Deckers, Maria Angeles Alonso Garcia, Werner W Klein, John Lekakis, Bertil Lindahl, Gianfranco Mazzotta, João Carlos Araujo Morais, Ali Oto, Otto Smiseth, Hans-Joachim Trappe. (2003) ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias —executive summary. Journal of the American College of Cardiology 42:8, 1493-1531
CrossRef37
L Wang. (2003) Radiofrequency catheter ablation of accessory pathway-mediated tachycardia is a safe and effective long-term therapy. Archives of Medical Research 34:5, 394-398
CrossRef38
Gerald V. Naccarelli, John Hynes, Deborah L. Wolbrette, Luna Bhatta, Mazhar Khan, Jerry Luck. (2002) Maintaining stability of sinus rhythm in atrial fibrillation: Antiarrhythmic drugs versus ablation. Current Cardiology Reports 4:5, 418-425
CrossRef39
Izzet Erdinler, Ertan Okmen, Enis Oguz, Ahmet Akyol, Kadir Gurkan, Tanju Ulufer. (2002) Differentiation of Narrow QRS Complex Tachycardia Types Using the 12-Lead Electrocardiogram. Annals of Noninvasive Electrocardiology 7:2, 120-126
CrossRef40
Paul LeLorier, George J. Klein, Andrew Krahn, Raymond Yee, Allan Skanes. (2001) Should patients with asymptomatic wolff-parkinson-white pattern undergo a catheter ablation?. Current Cardiology Reports 3:4, 301-304
CrossRef41
Hugh Calkins. (2001) Catheter Ablation for Cardiac Arrhythmias. Medical Clinics of North America 85:2, 473-502
CrossRef42
A.J. Greenspon. (2000) Advances in catheter ablation for the treatment of cardiac arrhythmias. IEEE Transactions on Microwave Theory and Techniques 48:12, 2670-2675
CrossRef43
FRANCES VEGA-ARRILLAGA, MING-LON YOUNG, JING-MING WU, GRACE S. WOLFF. (2000) Initial Low Temperature Setting in Radiofrequency Catheter Ablation of Wolff-Parkinson-White Syndrome. Pacing and Clinical Electrophysiology 23:12, 2097-2100
CrossRef44
CATHY LAM, ROBERT SCHWEIKERT, LOGAN KANAGARATNAM, ANDREA NATALE. (2000) Radiofrequency Ablation of a Right Atrial Appendage Ventricular Accessory Pathway by Transcutaneous Epicardial Instrumentation. Journal of Cardiovascular Electrophysiology 11:10, 1170-1173
CrossRef45
Bradley P. Knight, Fred Morady. (2000) Supraventricular tachyarrhythmia. Current Treatment Options in Cardiovascular Medicine 2:4, 297-308
CrossRef46
Melvin M. Scheinman. (2000) Nonpharmacologic Management of Supraventricular Tachycardia. The American Journal of Geriatric Cardiology 9:3, 159-162
CrossRef47
REGINA BÖKENKAMP, GUDRUN WIBBELT, MATTHIAS STURM, BRITTA WINDHAGEN-MAHNERT, HARALD BERTRAM, GERD HAUSDORF, THOMAS PAUL. (2000) Effects of Intracardiac Radiofrequency Current Application on Coronary Artery Vessels in Young Pigs. Journal of Cardiovascular Electrophysiology 11:5, 565-571
CrossRef48
BRIAN A. VANDERBRINK, CHARLES GILBRIDE, MARK J. ARONOVITZ, TIM LENIHAN, GREG SCHORN, KEVIN TAYLOR, JAMES F. REGAN, KENNETH CARR, FREDERICK J. SCHOEN, MARK S. LINK, MUNTHER K. HOMOUD, N.A. MARK ESTES, PAUL J. WANG. (2000) Safety and Efficacy of a Steerable Temperature Monitoring Microwave Catheter System for Ventricular Myocardial Ablation. Journal of Cardiovascular Electrophysiology 11:3, 305-310
CrossRef49
PITAYADET JUMRUSSIRIKUL, WALTER L. ATIGA, ALBERT C. LARDO, RONALD D. BERGER, HENRY HALPERIN, GROVER M. HUTCHINS, HUGH CALKINS. (2000) Prospective Comparison of Lesions Created Using a Multipolar Microcatheter Ablation System with Those Created Using a Fullback Approach with Standard Radiofrequency Ablation in the Canine Atrium. Pacing and Clinical Electrophysiology 23:2, 203-213
CrossRef50
BRIAN A. VANDERBRINK, ZEJI GU, VICTOR RODRIGUEZ, MARK S. LINK, MUNTHER K. HOMOUD, N.A. MARK ESTES III, CAREY M. RAPPAPORT, PAUL J. WANG. (2000) Microwave Ablation Using a Spiral Antenna Design in a Porcine Thigh Muscle Preparation: In Vivo Assessment of Temperature Profile and Lesion Geometry. Journal of Cardiovascular Electrophysiology 11:2, 193-198
CrossRef51
Erica S Zado, David J Callans, Charles D Gottlieb, Steven P Kutalek, Sabrina L Wilbur, Fania L Samuels, Scott E Hessen, Colin M Movsowitz, John M Fontaine, Stephen E Kimmel, Francis E Marchlinski. (2000) Efficacy and safety of catheter ablation in octogenarians. Journal of the American College of Cardiology 35:2, 458-462
CrossRef52
Riccardo Cappato, Karl-Heinz Kuck. (2000) Catheter ablation in the year 2000. Current Opinion in Cardiology 15:1, 29-40
CrossRef53
YUKIHIKO YOSHIDA, MAKOTO HIRAI, YOSHIMASA MURAKAMI, TAKAHISA KONDO, YASUYA INDEN, MAKOTO AKAHOSHI, MAKOTO TSUDA, MITSUHIRO OKAMOTO, TAKUMI YAMADA, NAOYA TSUBOI, HARUO HIRAYAMA, TERUO ITO, JUNJI TOYAMA, HIDEHIKO SAITO. (1999) Localization of Precise Origin of Idiopathic Ventricular Tachycardia from the Right Ventricular Outflow Tract by a 12-Lead ECG: A Study of Pace Mapping Using a Multielectrode "Basket" Catheter. Pacing and Clinical Electrophysiology 22:12, 1760-1768
CrossRef54
KARIM KHALIFE, JACQUES BILLETTE, DJAMILA MEDKOUR, KARYNE MARTEL, MAURICE TREMBLAY, JUN WANG, LI-JEN LIN. (1999) Role of the Compact Node and Its Posterior Extension in Normal Atrioventricular Nodal Conduction, Refractory, and Dual Pathway Properties. Journal of Cardiovascular Electrophysiology 10:11, 1439-1451
CrossRef55
MARC DUBUC, DENIS ROY, BERNARD THIBAULT, ANIQUE DUCHARME, JEAN-CLAUDE TARDIF, CHRISTINE VILLEMAIRE, TACKKI LEUNG, MARIO TALAJIC. (1999) Transvenous Catheter Ice Mapping and Cryoablation of the Atrioventricular Node in Dogs. Pacing and Clinical Electrophysiology 22:10, 1488-1498
CrossRef56
TAREK BASIOUNY, CHRISTIAN CHILLOU, SAMIR FAREH, GILBERT KIRKORIAN, MARC MESSIER, NICOLAS SADOUL, PHILLIPE CHEVALIER, ISABELLE MAGNIN-POULL, IVAN BLANKOFF, JIAN CHEN, PAUL TOUBOUL, ETIENNE ALIOT. (1999) Accuracy and Limitations of Published Algorithms Using the Twelve-Lead Electrocardiogram to Localize Overt Atrioventricular Accessory Pathways. Journal of Cardiovascular Electrophysiology 10:10, 1340-1349
CrossRef57
FRANCISCO G. COSÍO, ROBERT H. ANDERSON, KARL-HEINZ KUCK, ANTON BECKER, DAVID G. BENDITT, SAROJA BHARATI, MARTIN BORGGREFE, RONALD W.F. CAMPBELL, FIORENZO GAITA, GERARD M. GUIRAUDON, MICHEL HAÏSSAGUERRE, GEORGE KLEIN, JONATHAN LANGBERG, FRANCIS MARCHLINSKI, JUAN J. RUFILANCHAS, SANJEEV SAKSENA, GAETANO THIENE, HEIN JJ. WELLENS. (1999) ESCWGA/NASPE/P Experts Consensus Statement:.. Journal of Cardiovascular Electrophysiology 10:8, 1162-1170
CrossRef58
LI-JEN LIN, JACQUES BILLETTE, KARIM KHALIFE, KARYNE MARTEL, JUN WANG, DJAMILA MEDKOUR. (1999) Characteristics, Circuit, Mechanism, and Ablation of Reentry in the Rabbit Atrioventricular Node. Journal of Cardiovascular Electrophysiology 10:7, 954-964
CrossRef59
S. ADAM STRICKBERGER, TAKASHA TOKANO, HUNG FAT TSE, MICHAEL H. KIM, HAKAN ORAL, MATTHEW FLEMMING, FRANK PELOSI, GREGORY F. MICHAUD, BRADLEY P. KNIGHT, RAJIVA GOYAL, FRED MORADY. (1999) Target Temperatures of 48
C versus 60
CrossRef60
David J Callans, Jian-Fang Ren, David Schwartzman, Charles D Gottlieb, Farooq A Chaudhry, Francis E Marchlinski. (1999) Narrowing of the superior vena cava–right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: analysis with intracardiac echocardiography. Journal of the American College of Cardiology 33:6, 1667-1670
CrossRef61
LI ZHOU, DAVID KEANE, GUY REED, JEREMY RUSKIN. (1999) Thromboembolic Complications of Cardiac Radiofrequency Catheter Ablation.. Journal of Cardiovascular Electrophysiology 10:4, 611-620
CrossRef62
CHING-TAI TAI, SHIH-ANN CHEN, CHERN-EN CHIANG, MAU-SONG CHANG. (1999) Characteristics and Radiofrequency Catheter Ablation of Septal Accessory Atrioventricular Pathways. Pacing and Clinical Electrophysiology 22:3, 500-511
CrossRef63
Wood, Alastair J.J., , Morady, Fred, . (1999) Radio-Frequency Ablation as Treatment for Cardiac Arrhythmias. New England Journal of Medicine 340:7, 534-544
Full Text64
Parvin C Dorostkar, Michael J Silka, Fred Morady, Macdonald Dick. (1999) Clinical course of persistent junctional reciprocating tachycardia. Journal of the American College of Cardiology 33:2, 366-375
CrossRef65
Anja Tuchnitz, Claus Schmitt, Helene von Bibra, Michael A.E. Schneider, Andreas Plewan, Albert Schömig. (1999) Noninvasive Localization of Accessory Pathways in Patients with Wolff-Parkinson-White Syndrome with the Use of Myocardial Doppler Imaging. Journal of the American Society of Echocardiography 12:1, 32-40
CrossRef66
Koichi Mizumaki, Akira Fujiki, Masahiro Usui, Mayumi Shimono, Hideki Hayashi, Hidehiko Nagasawa, Hiroshi Inoue. (1999) Changes in Autonomic Nervous Activity After Catheter Ablation of Right Ventricular Outflow Tract Tachycardia. Japanese Circulation Journal 63:9, 697-703
CrossRef67
Sanjaya Khanal, Paulo A. Ribeiro, Marc Platt, Micheal A. Kuhn. (1999) Right coronary artery occlusion as a complication of accessory pathway ablation in a 12-year-old treated with stenting. Catheterization and Cardiovascular Interventions 46:1, 59-61
CrossRef68
Ichiro Watanabe, Satoshi Kunimoto, Kazuhiko Kondo, Toshiaki Kojima, Toshiko Nakai, Atsushi Shindo, Naohiro Oshikawa, Satoshi Saito, Yukio Ozawa, Katsuo Kanmatsuse. (1999) Radiofrequency Catheter Ablation of Coexistent Atrioventricular Reciprocating Tachycardia and Left Ventricular Tachycardia Originating in the Left Anterior Fascicle. Japanese Circulation Journal 63:3, 223-227
CrossRef69
Jean-Claude Tardif, Peter W. Groeneveld, Paul J. Wang, Connor J. Haugh, N.A.Mark Estes, Steven L. Schwartz, Natesa G. Pandian. (1999) Intracardiac Echocardiographic Guidance During Microwave Catheter Ablation. Journal of the American Society of Echocardiography 12:1, 41-47
CrossRef70
LISA L. SKRUMEDA, RAHUL MEHRA. (1998) Comparison of Standard and Irrigated Radiofrequency Ablation in the Canine Ventricle. Journal of Cardiovascular Electrophysiology 9:11, 1196-1205
CrossRef71
KARLHEINZ SEIDL, BERND HAUER, RALF ZAHN, JOCHEN SENGES. (1998) Unexpected Complete AV Block Following Transcatheter Ablation of a Left Posteroseptal Accessory Pathway. Pacing and Clinical Electrophysiology 21:11, 2139-2142
CrossRef72
JIAN-FANG REN, DAVID SCHWARTZMAN, DAVID J. CALLANS, FRANCIS E. MARCHLINSKI, LI-PING ZHANG, FAROOQ A. CHAUDHRY. (1998) Intracardiac Echocardiographic Imaging in Guiding and Monitoring Radiofrequency Catheter Ablation at the Tricuspid Annulus. Echocardiography 15:7, 661-664
CrossRef73
ATSUSHI TAKAHASHI, DIPEN C. SHAH, PIERRE JAÏS, MELEZE HOCINI, JACQUES CLEMENTY, MICHEL HAÏSSAGUERRE. (1998) Specific Electrocardiographic Features of Manifest Coronary Vein Posteroseptal Accessory Pathways. Journal of Cardiovascular Electrophysiology 9:10, 1015-1025
CrossRef74
KAZUHIRO SUYAMA, TAKASHI KURITA, WATARU SHIMIZU, KIYOTAKA MATSUO, ATSUSHI TAGUCHI, NAOHIKO AIHARA, SHIRO KAMAKURA, KATSURO SHIMOMURA. (1998) Radiofrequency Catheter Ablation of Concealed Atrioventricular Accessory Pathways Using a "Simultaneous Pacing Method". Pacing and Clinical Electrophysiology 21:9, 1693-1699
CrossRef75
LOUIS F. JANEIRA. (1998) Coronary Artery Dissection Complicating Radiofrequency Catheter Ablation via the Retrograde Approach. Pacing and Clinical Electrophysiology 21:6, 1327-1328
CrossRef76
Gerhard Hindricks, Hans Kottkamp, Martin Borggrefe, Günter Breithardt. (1998) Hochfrequenzstrom-Katheterablation akzessorischer Leitungsbahnen. Herz 23:4, 219-230
CrossRef77
MATTHIAS ANTZ, BENJAMIN J. SCHERLAG, KENICHIRO OTOMO, JAN PITHA, CLAUDIO TONDO, EUGENE PATTERSON, WARREN M. JACKMAN, RALPH LAZZARA. (1998) Evidence for Multiple Atrio-AV Nodal Inputs in the Normal Dog Heart. Journal of Cardiovascular Electrophysiology 9:4, 395-408
CrossRef78
JOSEP BRUGADA. MARTIPUIGFEL, LLUIS MONT, IGNACIO GARCIA BOLAO, MARCIO FIGUEIREDO, MARIONA MATAS, FRANCISCO NAVARRO-LOPEZ. (1998) Radiofrequency Ablation of Anteroseptal, Para-Hisian, and Mid-Septal Accessory Pathways Using a Simplified Femoral Approach. Pacing and Clinical Electrophysiology 21:4, 735-741
CrossRef79
Klaus-Peter Kunze, Bernd Hayen, Manfred Geiger. (1998) Ambulante Katheterablation. Herz 23:2, 135-140
CrossRef80
F. Bogun, F. Morady. (1998) Outpatient radiofrequency catheter ablation. Herz 23:1, 42-46
CrossRef81
JOHN T.Y. HII, RONALD D. WUTTKE, MARTHA KALABURNIS, GEORGIA VELISARRIS. (1998) Feasibility and Safety of a Minimally Invasive Approach to Catheter Ablation for Atrioventricular Nodal Reentrant Tachycardia. Pacing and Clinical Electrophysiology 21:1, 308-310
CrossRef82
Helmut P. Weber, Armin Heinze, Susanne Enders, Lutz Ruprecht, Eberhard Unsöld. (1998) Laser catheter coagulation of normal and scarred ventricular myocardium in dogs. Lasers in Surgery and Medicine 22:2, 109-119
CrossRef83
Koji Azegami, Shutaro Satake, Kaoru Okishige, Tetsuo Sasano, Hiroshi Ohira, Katsuhiro Yamashita. (1998) Monitoring the Local Electrogram at the Ablation Site during Radiofrequency Application for Common Atrial Flutter. Japanese Circulation Journal 62:8, 559-564
CrossRef84
OLE-GUNNAR ANFINSEN, ERIK KONGSGAARD, ARNOLD FOERSTER, HALFDAN AASS, JAN P. AMLIE. (1998) Radiofrequency Current Ablation of Porcine Right Atrium: Increased Lesion Size with Bipolar Two Catheter Technique Compared to Unipolar Application In Vitro and In Vivo. Pacing and Clinical Electrophysiology 21:1, 69-78
CrossRef85
Leonardo A Orejarena, Humberto Vidaillet, Frank DeStefano, David L Nordstrom, Robert A Vierkant, Peter N Smith, John J Hayes. (1998) Paroxysmal Supraventricular Tachycardia in the General Population. Journal of the American College of Cardiology 31:1, 150-157
CrossRef86
J. M. Kalman, J. K. Vohra, S. Jayaprakash, P. B. Sparks. (1997) Radiofrequency ablation for cure of atrial flutter. Australian and New Zealand Journal of Medicine 27:6, 653-657
CrossRef87
GREGORY K. FELD, MICHAEL MOLLERUS, ULRIKA BIRGERSDOTTER-GREEN, OSAMU FUJIMURA, TRISTRAM D. BAHNSON, KER BOYCE, MARC RAHME. (1997) Conduction Velocity in the Tricuspid Valve-Inferior Vena Cava Isthmus is Slower in Patients With Type I Atrial Flutter Compared to Those Without a History of Atrial Flutter. Journal of Cardiovascular Electrophysiology 8:12, 1338-1348
CrossRef88
CLAUDIO TONDO, BENJAMIN J. SCHERLAG, KENICHIRO OTOMO, MATTHIAS ANTZ, EUGENE PATTERSON, MAURICIO ARRUDA, WARREN M. JACKMAN, RALPH LAZZARA. (1997) Critical Atrial Site for Ablation of Pacing-Induced Atrial Fibrillation in the Normal Dog Heart. Journal of Cardiovascular Electrophysiology 8:11, 1255-1265
CrossRef89
YOSHITO IESAKA, ATSUSHI TAKAHASHI, MASAHIKO GOYA, YOHKOH SOEJIMA, YOSHIHIRO OKAMOTO, HIDEOMI FUJIWARA, KAZUTAKA AONUMA, AKIHTKO NOGAMI, MICHIAKI HIROE, FUMIAKI MARUMO, MASAYASU HIRAOKA. (1997) Adenosine-Sensitive Atrial Reentrant Tachycardia Originating from the Atrioventricular Nodal Transitional Area. Journal of Cardiovascular Electrophysiology 8:8, 854-864
CrossRef90
KENZO HIRAO, BENJAMIN J. SCHERLAG, HERVE POTY, KENICHIRO OTOMO, CLAUDIO TONDO, MATTHIAS ANTZ, EUGENE PATTERSON, WARREN M. JACKMAN, RALPH LAZZARA. (1997) Electrophysiology of the Atrio-AV Nodal Inputs and Exits in the Normal Dog Heart.. Journal of Cardiovascular Electrophysiology 8:8, 904-915
CrossRef91
SVEN REEK, HELMUT U. KLEIN, RAYMOND E. IDEKER. (1997) Can Catheter Ablation in Cardiac Arrest Survivors Prevent Ventricular Fibrillation Recurrence?. Pacing and Clinical Electrophysiology 20:7, 1840-1859
CrossRef92
MAXIME PONS, LIONEL BECK, FLORENCE LECLERCQ, MARC FERRIERE, BERNARD ALBAT, JEAN-MARC DAVY. (1997) Chronic Left Main Coronary Artery Occlusion: A Complication of Radiofrequency Ablation of Idiopathic Left Ventricular Tachycardia. Pacing and Clinical Electrophysiology 20:7, 1874-1876
CrossRef93
CHING-FUNG TSAI, SHIH-ANN CHEN, CHERN-EN CHIANG, CHING TAI TAI, SHIH HUANG LEE, ZU-CHIN WEN, YI-JEN CHEN, WEN CHUNG YU, JIN-LONG HUANG, AN-NING FENG, MAU-SONG CHANG. (1997) Radiofrequency Ablation-Induced Asystole During Transaortic Approach for a Left Anterolateral Accessory Pathway.. Journal of Cardiovascular Electrophysiology 8:6, 694-699
CrossRef94
SHIMON ROSENHECK, MICHAL ROSE, ZEHAVA SHARON, TEDDY A. WEISS, MERVYN S. GOTSMAN. (1997) The Ongoing Influence of Staff Training on the Performance of Radiofrequency Catheter Ablation. Pacing and Clinical Electrophysiology 20:5, 1312-1317
CrossRef95
Charles Fisch, John M Mandrola, David P Rardon. (1997) Electrocardiographic Manifestations of Dual Atrioventricular Node Conduction During Sinus Rhythm. Journal of the American College of Cardiology 29:5, 1015-1022
CrossRef96
HANS KOTTKAMP, GERHARD HINDRICKS, MARTIN BORGGREFE, GÜNTER BREITHARDT. (1997) Radiofrequency Catheter Ablation of the Anterosuperior and Posteroinferior Atrial Approaches to the AV Node for Treatment of AV Nodal Reentrant Tachycardia.. Journal of Cardiovascular Electrophysiology 8:4, 451-468
CrossRef97
FRANCK MOLIN, PIERRE SAVARD, MARC DUBUC, TERESA KUS, GAETAN TREMBLAY, REGINALD NADEAU. (1997) Spatial Resolution and Role of Pacemapping During Ablation of Accessory Pathways. Pacing and Clinical Electrophysiology 20:3, 683-694
CrossRef98
JOSEP BRUGADA, IGNACIO GARCIA-BOLAO, MARCIO FIGUEIREDO, MARTÍ PUIGFEL, MARIONA MATAS, FRANCISCO NAVARRO-LÓPEZ. (1997) Radiofrequency Ablation of Concealed Left Free-Wall Accessory Pathways Without Coronary Sinus Catheterization:.. Journal of Cardiovascular Electrophysiology 8:3, 249-253
CrossRef99
JOHN J. GALLAGHER. (1997) Wolff-Parkinson-White Syndrome: Surgery to Radiofrequency Catheter Ablation. Pacing and Clinical Electrophysiology 20:2, 512-532
CrossRef100
K. Hynynen, J. Dennie, J.E. Zimmer, W.N. Simmons, Ding Sheng He, F.I. Marcus, M. Aguirre. (1997) Cylindrical ultrasonic transducers for cardiac catheter ablation. IEEE Transactions on Biomedical Engineering 44:2, 144-151
CrossRef101
Ching-Tai Tai, Shih-Ann Chen, Chern-En Chiang, Shih-Huang Lee, Zu-Chi Wen, Chuen-Wang Chiou, Kwo-Chang Ueng, Yi-Jen Chen, Wen-Chung Yu, Mau-Song Chang. (1997) A New Electrocardiographic Algorithm Using Retrograde P Waves for Differentiating Atrioventricular Node Reentrant Tachycardia From Atrioventricular Reciprocating Tachycardia Mediated by Concealed Accessory Pathway. Journal of the American College of Cardiology 29:2, 394-402
CrossRef102
Yohkoh Soejima, Yoshito Iesaka, Atsushi Takahashi, Masahiko Goya, Takeshi Tokunaga, Hiroshi Amemiya, Hideomi Fujiwara, Jun-ichi Nitta, Akihiko Nogami, Kazutaka Aonuma, Michiaki Hiroe, Fumiaki Marumo, Masayasu Hiraoka. (1997) Radiofrequency Catheter Ablation of Posteroseptal Atrioventricular Accessory PathWays. Japanese Circulation Journal 61:1, 46-54
CrossRef103
JOHN K. TRIEDMAN, KATHY J. JENKINS, STEVEN D. COLAN, RICHARD PRAAGH, JAMES E. LOCK, EDWARD P. WALSH. (1997) Multipolar Endocardial Mapping of the Right Heart Using a Basket Catheter: Acute and Chronic Animal Studies. Pacing and Clinical Electrophysiology 20:1, 51-59
CrossRef104
PAOLO VOCI, LUIGI TRITAPEPE, GIUSEPPE CRITELLI. (1997) Iatrogenic Pneumohemomediastinum Mimicking Cardiac Tamponade: A Complication of Catheter Ablation Procedure. Pacing and Clinical Electrophysiology 20:1, 138-139
CrossRef105
THOMAS PAUL, BRITTA MAHNERT, HANS J. TRAPPE, ANNE MAAss, REGINA BOKENKAMP, PETRA MEYER, REINHARD BRUCKNER. (1996) Lack of Evidence of Areas of Slow Conduction Early After Radiofrequency Current Application at Porcine Atrial Myocardium. Pacing and Clinical Electrophysiology 19:11, 2009-2013
CrossRef106
LUIS A. PIRES, SHOEI K. STEPHEN HUANG, ALAN B. WAGSHAL, FRANK MAZZOLA, PATRICK G. YOUNG, SUZAN MOSER, . (1996) Clinical Utility of Routine Transthoracic Echocardiographic Studies After Uncomplicated Radiofrequency Catheter Ablation: A Prospective Multicenter Study. Pacing and Clinical Electrophysiology 19:10, 1502-1507
CrossRef107
S. STRICKBERGER, RAUL WEISS, BRADLEY P. KNIGHT, MARWAN BAJU, FRANK BOGUN, KAREN BRINKMAN, MARK HARVEY, RAJIVA GOYAL, EMILE DAOUD, K. CHIN MAN, FRED MORADY. (1996) Randomized Comparison of Two Techniques for Titrating Power During Radiofrequency Ablation of Accessory Pathways. Journal of Cardiovascular Electrophysiology 7:9, 795-801
CrossRef108
NICHOLAS J. STAMATO, STEVEN L. EDDY, DEBRA J. WHITING. (1996) Transient Complete Heart Block During Radiofrequency Ablation of a Left Lateral Bypass Tract. Pacing and Clinical Electrophysiology 19:9, 1351-1354
CrossRef109
DAVID J. CALLANS, DAVID SCHWARTZMAN, CHARLES D. GOTTLIEB, FRANCIS E. MARCHLINSKI. (1996) Insights into the Electrophysiology of Accessory Path way-Mediated Arrhythmias Provided by the Catheter Ablation Experience:.. Journal of Cardiovascular Electrophysiology 7:9, 877-904
CrossRef110
S. M. Schwartz, M. Dick, P. C. Dorostkar, G. A. Serwer, S. LeRoy. (1996) Electrogram patterns associated with successful radiofrequency ablation of accessory pathways in children. Pediatric Cardiology 17:3, 137-142
CrossRef111
JURGEN TEBBENJOHANNS, DIETRICH PFEIFFER, BURGHARD SCHUMACHER, WERNER JUNG, MATTHIAS MANZ, BERNDT LUDERITZ. (1996) Direct Angiography of the Coronary Sinus: Impact on Left Posteroseptal Accessory Pathway Ablation. Pacing and Clinical Electrophysiology 19:7, 1075-1081
CrossRef112
ANNIBALE SANDRO MONTENERO, FILIPPO CREA, MARIA GRAZIA BENDINI, GEMMA PELARGONIO, ANSELMA INTINI, MARIA LUISA FINOCCHIARO, FRANCESCO BISCIONE, FABIO PIGOZZI, FULVIO BELLOCCI, PAOLO ZECCHI. (1996) Electrograms for Identification of the Atrial Ablation Site During Catheter Ablation of Accessory Pathways. Pacing and Clinical Electrophysiology 19:6, 905-912
CrossRef113
JÚRG SCHLÄPFER, LUKAS KAPPENBERGER, MARTIN FROMER. (1996) Bezold-Jarisch-Like Phenomenon Induced by Radiofrequency Ablation of a Left Posteroseptal Accessory Pathway via the Coronary Sinus. Journal of Cardiovascular Electrophysiology 7:5, 445-449
CrossRef114
GUILHERME FENELON, PEDRO BRUGADA. (1996) Delayed Effects of Radiofrequency Energy: Mechanisms and Clinical Implications. Pacing and Clinical Electrophysiology 19:4, 484-489
CrossRef115
HANS KOTTKAMP, XU CHEN, GERHARD HINDRICKS, THOMAS WICHTER, STEPHAN WILLEMS, SINNIKA YLI-MÄYRY, GÜNTER BREITHARDT, MARTIN BORGGREFE. (1996) Temperature-controlled Radiofrequency Catheter Ablation of Accessory Pathways and Atrioventricular Nodal Reentrant Tachycardia: The 5-French Catheter Approach. Journal of Cardiovascular Electrophysiology 7:3, 206-210
CrossRef116
FUMIO SUZUKI, TOSHIMASA TOSAKA, HIDENOBU ASHIKAWA, KOHICHI ASAMI, HIROKO NAWATA, NAOKO ISHIHARA, TOMOKO TERAI, KATSUHIKO MOTOKAWA, KENZO HIRAO, TOKUHIRO KAWARA, KAZUMASA HIEJIMA. (1996) Earlier Activation of the Distal than the Proximal Site of the Coronary Sinus May Represent Retrograde Conduction Through AV Node: Significance of Recording of Far Distal Coronary Sinus. Pacing and Clinical Electrophysiology 19:3, 331-341
CrossRef117
I.D. McRury, D.E. Haines. (1996) Ablation for the treatment of arrhythmias. Proceedings of the IEEE 84:3, 404-416
CrossRef118
Burt I. Bromberg, Bruce D. Lindsay, Michael E. Cain, James L. Cox. (1996) Impact of clinical history and electrophysiologic characterization of accessory pathways on management strategies to reduce sudden death among children with Wolff-Parkinson-White syndrome. Journal of the American College of Cardiology 27:3, 690-695
CrossRef119
KELLY J. TUCKER, ANNE B. CURTIS, JAMES MURPHY, JAMIE B. CONTI, D. JAMES KAZAKIS, EDWARD A. GEISER, C. RICHARD CONTI. (1996) Transesophageal Echocardiographic Guidance of Transseptal Left Heart Catheterization During Radiofrequency Ablation of Left-Sided Accessory Pathways in Humans. Pacing and Clinical Electrophysiology 19:3, 272-281
CrossRef120
JAY L. DINERMAN, RONALD D. BERGER, HUGH CALKINS. (1996) Temperature Monitoring During Radiofrequency Ablation. Journal of Cardiovascular Electrophysiology 7:2, 163-173
CrossRef121
GUILHERME FENELON, WILLIAM WIJNS, ERIK ANDRIES, PEDRO BRUGADA. (1996) Tachycardiomyopathy: Mechanisms and Clinical Implications. Pacing and Clinical Electrophysiology 19:1, 95-106
CrossRef122
MOHAMMAD R. JAZAYERI. (1995) Detailed Mapping for Catheter Ablation of Left-Sided Accessory Pathways: Search for the "Magic" Signals From A to V and W to Z. Journal of Cardiovascular Electrophysiology 6:12, 1077-1080
CrossRef123
ANNIBALE SANDRO MONTENERO, FILIPPO CREA, MARIA GRAZIA BENDINI, FULVIO BELLOCCI, PAOLO ZECCHI. (1995) Catheter Ablation of Left Accessory Atrioventricular Connections: The Transseptal Approach. Journal of Interventional Cardiology 8:s6, 806-812
CrossRef124
R. DENT UNDERWOOD, SANJAY S. DESHPANDE, MICHAEL BIEHL, MARK COWAN, MASOOD AKHTAR, MOHAMMAD R. JAZAYERI. (1995) Radiofrequency Catheter Ablation of Multiple Morphologies of Ventricular Tachycardia by Targeting a Single Region of the Left Ventricle. Journal of Cardiovascular Electrophysiology 6:11, 1015-1022
CrossRef125
WOLFGANG M. HARTUNG, M. ERICK BURTON, A. GREGORY DEAM, PAUL F. WALTER, KEVIN McTEAGUE, JONATHAN J. LANGBERG. (1995) Estimation of Temperature During Radiofrequency Catheter Ablation Using Impedance Measurements. Pacing and Clinical Electrophysiology 18:11, 2017-2021
CrossRef126
SHIH-ANN CHEN, CHERN-EN CHIANG, CHING-TAI TAI, SHIH-HUANG LEE, MAU-SONG CHANG. (1995) Future Ablation Concepts of Tachyarrhythmias. Journal of Cardiovascular Electrophysiology 6:10, 852-862
CrossRef127
Dennis Wei-Xi Zhu, James D. Maloney, Tony W. Simmons, Junichi Nitta, David M. Fitzgerald, Richard G. Trohman, Dirar S. Khoury, Walid Saliba, Karen M. Belco, Carlos Rizo-Patron, Sergio L. Pinski. (1995) Radiofrequency catheter ablation for management of symptomatic ventricular ectopic activity. Journal of the American College of Cardiology 26:4, 843-849
CrossRef128
Hein J.J. Wellens. (1995) Radiofrequency catheter ablation of benign ventricular ectopic beats: A therapy in search of a disease?. Journal of the American College of Cardiology 26:4, 850-851
CrossRef129
ANDRE d'AVILA, JOSEP BRUGADA, VASSILIS SKEBERIS, ERIK ANDRIES, EDUARDO SOSA, PEDRO BRUGADA. (1995) A Fast and Reliable Algorithm to Localize Accessory Pathways Based on the Polarity of the QRS Complex on the Surface ECG During Sinus Rhythm. Pacing and Clinical Electrophysiology 18:9, 1615-1627
CrossRef130
James L. Ritchie. (1995) ACC/AHA Guidelines for Clinical Intracardiac Electrophysiological and Catheter Ablation Procedures. Journal of Cardiovascular Electrophysiology 6:8, 654-679
CrossRef131
ADAM P. FITZPATRICK. (1995) The ECG in Wolff-Parkinson-White Syndrome. Pacing and Clinical Electrophysiology 18:8, 1469-1473
CrossRef132
Douglas P. Zipes, John P. Dimarco, Paul C. Gillette, Warren M. Jackman, Robert J. Myerburg, Shahbudin H. Rahimtoola, James L. Ritchie, Melvin D. Cheitlin, Arthur Garson, Raymond J. Gibbons, Richard P. Lewis, Robert A. O'Rourke, Thomas J. Ryan, Robert C. Schlant. (1995) Guidelines for clinical intracardiac electrophysiological and catheter ablation procedures. Journal of the American College of Cardiology 26:2, 555-573
CrossRef133
DANIEL B. FRAM, ELLISON BERNS, THOMAS ARETZ, LINDA D. GILLAM, JOSEPH S. MIKAN, DAVID WATERS, RAYMOND G. McKAY. (1995) Feasibility of Radiofrequency Powered, Thermal Balloon Ablation of Atrioventricular Bypass Tracts Via the Coronary Sinus: In Vivo Canine Studies. Pacing and Clinical Electrophysiology 18:8, 1518-1530
CrossRef134
Ricardo A. Samson, Barbara J. Deal, Janette F. Strasburger, D. Woodrow Benson. (1995) Comparison of transesophageal and intracardiac electrophysiologic studies in characterization of supraventricular tachycardia in pediatric patients. Journal of the American College of Cardiology 26:1, 159-163
CrossRef135
Chern-En Chiang, Shih-Ann Chen, Wee Siong Teo, Der-Shang Tsai, Tsu-Juey Wu, Chen-Chuan Cheng, Chuen-Wang Chiou, Ching-Tai Tai, Shih-Huang Lee, Chung-Yin Chen, Shih-Pu Wang, Benjamin N. Chiang, Arthur Tan, Mau-Song Chang. (1995) An Accurate Stepwise Electrocardiographic Algorithm for localization of Accessory Pathways in Patients With Wolff-Parkinson-White Syndrome from a Comprehensive Analysis of Delta Waves and R/S Ratio During Sinus Rhythm. The American Journal of Cardiology 76:1-2, 40-46
CrossRef136
ROBERT S. MITTLEMAN, SHOEI K. STEPHEN HUANG, WILSON GUZMAN, HENRI CUENOUD, ALAN B. WAGSHAL, LUIS A. PIRES. (1995) Use of the Saline Infusion Electrode Catheter for Improved Energy Delivery and Increased Lesion Size in Radiofrequency Catheter Ablation. Pacing and Clinical Electrophysiology 18:5, 1022-1027
CrossRef137
Fred Morady. (1995) Fast pathway ablation for atrioventricular node reentrant tachycardia. Journal of the American College of Cardiology 25:5, 982-983
CrossRef138
SANJEEV SAKSENA, ANDREW E. EPSTEIN, RALPH LAZZARA, JAMES D. MALONEY, DOUGLAS P. ZIPES, DAVID G. BENDITT, A. JOHN CAMM, MICHAEL J. DOMANSKI, JOHN D. FISHER, BERNARD J. GERSH, GERVASIO A. LAMAS, MICHAEL H. LEHMANN, DANIEL E. NICKELSON, ERIC N. PRYSTOWSKY, D. GEORGE WYSE. (1995) Clinical Investigation of Antiarrhythmic Devices: A Statement for Healthcare Professionals From a Joint Task Force of the North American Society of Pacing and Electrophysiology, the American College of Cardiology, the American Heart Association, and the Working Groups on Arrhythmias and Cardiac Pacing of the European Society of Cardiology. Pacing and Clinical Electrophysiology 18:4, 637-654
CrossRef139
IAN D. McRURY, JAMES G. WHAYNE, DAVID E. HAINES. (1995) Temperature Measurement as a determinant of Tissue Heating During Radiofrequency Catheter ablation: An Examination of Electrode Thermistor Positioning for Measurement Accuracy. Journal of Cardiovascular Electrophysiology 6:4, 268-278
CrossRef140
Hans Kottkamp, Gerhard Hindricks, Stephan Willems, Xu Chen, Lutz Reinhardt, Wilhelm Haverkamp, Günter Breithardt, Martin Borggrefe. (1995) An anatomically and electrogram-guided stepwise approach for effective and safe catheter ablation of the fast pathway for elimination of atrioventricular node reentrant tachycardia. Journal of the American College of Cardiology 25:5, 974-981
CrossRef141
Sanjeev Saksena, Andrew E. Epstein, Ralph Lazzara, James D. Maloney, Douglas P. Zipes, David G. Benditt, A. John Camm, Michael J. Domanski, John D. Fisher, Bernard J. Gersh, Gervasio A. Lamas, Michael H. Lehmann, Daniel E. Nickelson, Eric N. Prystowsky, D. George Wyse. (1995) Clinical investigation of antiarrhythmic devices. Journal of the American College of Cardiology 25:5, 961-973
CrossRef142
A KADISH, J GOLDBERGER. (1995) Ablative therapy for atrioventricular nodal reentry arrhythmias. Progress in Cardiovascular Diseases 37:5, 273-294
CrossRef143
CHU-PAK LAU, YAU-TING TAI, PETER W.H. LEE. (1995) The Effects of Radiofrequency Ablation Versus Medical Therapy on the Quality-of-Life and Exercise Capacity in Patients with Accessory Pathway-Mediated Supraventricular Tachycardia: A Treatment Comparison Study. Pacing and Clinical Electrophysiology 18:3, 424-432
CrossRef144
V PLUMB. (1995) Catheter ablation of the accessory pathways of the Solff-Parkinson-White syndrome and its variants. Progress in Cardiovascular Diseases 37:5, 295-306
CrossRef145
GREGORY K. FELD. (1995) Radiofrequency Catheter Ablation Versus Modification of the AV Node for Control of Rapid Ventricular Response in Atrial Fibrillation. Journal of Cardiovascular Electrophysiology 6:3, 217-228
CrossRef146
RAJ R. KAUSHIK. (1995) Surgery for Cardiac Arrhythmias. Journal of Interventional Cardiology 8:1, 83-88
CrossRef147
H.J. TRAPPE, T. PAUL, P. PFITZNER, P.R. LICHTLEN. (1995) Transcatheter Ablation of Incessant Ectopic Left Atrial Tachycardia Using Radiofrequency Current. Journal of Interventional Cardiology 8:1, 3-8
CrossRef148
DIETRICH PFEIFFER, JÜRGEN TEBBENJOHANNS, BURGHARD SCHUMACHER, HEYDER OMRAN, WOLFGANG FEHSKE, BERNDT LÜDERITZ. (1995) Radiofrequency Catheter Ablation of Septal Accessory Pathways. Journal of Interventional Cardiology 8:1, 69-76
CrossRef149
Gerhard Hindricks, Hans Kottkamp, Xu Chen, Stephan Willems, Wilhelm Haverkamp, Mohammad Shenasa, Breithardt Günter, Martin Borggrefe. (1995) Localization and radiofrequency catheter ablation of left-sided accessory pathways during atrial fibrillation Feasibility and electrogram criteria for identification of appropriate target sites. Journal of the American College of Cardiology 25:2, 444-451
CrossRef150
MOHAMMAD R. JAZAYERI, ANWER DHALA, SANJAY DESHPANDE, ZALMEN BLANCK, JASBIR SRA, MASOOD AKHTAR. (1995) Posteroseptal Accessory Pathways: An Overview of Anatomical Characteristics, Electrocardiographic Patterns, Electrophysiological Features, and Ablative Therapy. Journal of Interventional Cardiology 8:1, 89-101
CrossRef151
YU-ZHI GE, PEI-ZHEN SHAO, JEFFREY GOLDBERGER, ALAN KADISH. (1995) Cellular Electrophysiological Changes Induced In Vitro by Radiofrequency Current: Comparison with Electrical Ablation. Pacing and Clinical Electrophysiology 18:2, 323-333
CrossRef152
SANJAY DESHPANDE, MOHAMMAD JAZAYERI, ANWER DHALA, ZALMEN BLANCK, JASBIR SRA, MASOOD AKHTAR. (1995) Catheter Ablation in Supraventricular Tachyarrhythmias. Journal of Interventional Cardiology 8:1, 59-67
CrossRef153
DAVID E. HAINES, JAMES G. WHAYNE, JEFFERY WALKER, SUNIL NATH, DAVID E. BRUNS. (1995) The Effect of Radiofrequency Catheter Ablation on Myocardial Creatine Kinase Activity. Journal of Cardiovascular Electrophysiology 6:2, 79-88
CrossRef154
Ganz, Leonard I., Friedman, Peter L., . (1995) Supraventricular Tachycardia. New England Journal of Medicine 332:3, 162-173
Full Text155
James C. Lin, Karen J. Beckman, Robert J. Hariman, Saroja Bharati, Maurice Lev, Yu-Jin Wang. (1995) Microwave ablation of the atrioventricular junction in open-chest dogs. Bioelectromagnetics 16:2, 97-105
CrossRef156
Edward Chu, Jonathan M. Kalman, Michael A. Kwasman, John C.Y. Jue, Peter J. Fitzgerald, Laurence M. Epstein, Nelson B. Schiller, Paul G. Yock, Michael D. Lesh. (1994) Intracardiac echocardiography during radiofrequency catheter ablation of cardiac arrhythmias in humans. Journal of the American College of Cardiology 24:5, 1351-1357
CrossRef157
GERALD L. LeCARPENTIER, JOHN J. BAGA, HUA YANG, RUSSELL T. STEINMAN, MARC D. MEISSNER, MICHAEL H. LEHMANN. (1994) Differentiation of Sinus Tachycardia From Ventricular Tachycardia with 1:1 Ventriculoatrial Conduction in Dual Chamher Implantable Cardioverter Defibrillators: Feasibility of a Criterion Based on the Atrioventricular Interval. Pacing and Clinical Electrophysiology 17:11, 1818-1831
CrossRef158
JAMIE B. CONTI, EDWARD GEISER, ANNE B. CURTIS. (1994) Catheter Entrapment in the Mitral Valve Apparatus During Radiofrequency Ablation. Pacing and Clinical Electrophysiology 17:10, 1681-1685
CrossRef159
OTTO H.P. TEIXEIRA, SESHADRI BALAJI, CHRISTOPHER L. CASE, PAUL C. GILLETTE. (1994) Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia in Children. Pacing and Clinical Electrophysiology 17:10, 1621-1626
CrossRef160
ERIK KONGSGAARD, ARNOLD FOERSTER, HALFDAN AASS, STEINAR MADSEN, JAN P. AMLIE. (1994) Power and Temperature Guided Radiofrequency Catheter Ablation of the Right Atrium in Pigs. Pacing and Clinical Electrophysiology 17:10, 1610-1620
CrossRef161
John D. Fisher, Michael E. Cain, Keith C. Ferdinand, Charles Fisch, J.Ward Kennedy, Steven P. Kutalek, Charles R. Lambert, Steven E. Nissen, Okike Nsidinanya Okike, Thomas Ryan, Sanjeev V. Saksena, Heinrich R. Schelbert, John S. Schroeder, David O. Williams. (1994) Catheter ablation for cardiac arrhythmias: Clinical applications personnel and facilities. Journal of the American College of Cardiology 24:3, 828-833
CrossRef162
JOSEPH SARNOSKI, TANVIR BAJWA, SANJAY DESHPANDE, DONALD H. SCHMIDT, RAMI GAL. (1994) Transesophageal Echocardiography During Radiofrequency Ablation of Left-Sided Free Wall Atrioventricular Accessory Pathways in Wolff-Parkinson-White Syndrome. Echocardiography 11:5, 461-467
CrossRef163
S. ADAM STRICKBERGER, EMILE DAOUD, MARK NIEBAUER, BRIAN D. WILLIAMSON, K. CHING MAN, JOHN D. HUMMEL, FRED MORADY. (1994) Effects of Partial and Complete Ablation of the Slow Pathway on Fast Pathway Properties in Patients with Atrioventricular Nodal Reentrant Tachycardia. Journal of Cardiovascular Electrophysiology 5:8, 645-649
CrossRef164
XU CHEN, HANS KOTTKAMP, GERHARD HINDRICKS, STEPHAN WILLEMS, WILHELM HAVERKAMP, ANTONIO MARTINEZ-RUBIO, BRIGITE ROTMAN, MOHAMMAD SHENASA, GÜNTER BREITHARDT, MARTIN BORGGREFE. (1994) Recurrence and Late Block of Accessory Pathway Conduction Following Radiofrequency Catheter Ablation. Journal of Cardiovascular Electrophysiology 5:8, 650-658
CrossRef165
MICHEL HAÏSSAGUERRE, FIORENZO GAÏTA, FRANK I. MARCUS, JACQUES CLÉMENTY. (1994) Radiofrequency Catheter Ablation of Accessory Pathways:.. Journal of Cardiovascular Electrophysiology 5:6, 532-552
CrossRef166
Jürg Schläpfer, Jean-Jacques Goy. (1994) Radiofrequency catheter ablation of both atrial ventricular nodal reentrant and atrial ventricular reentrant tachycardia in a single session. Clinical Cardiology 17:6, 337-339
CrossRef167
Kugler, John D.Danford, David A.Deal, Barbara J.Gillette, Paul C.Perry, James C.Silka, Michael J.Van Hare, George F.Walsh, Edward P.. (1994) Radiofrequency Catheter Ablation for Tachyarrhythmias in Children and Adolescents. New England Journal of Medicine 330:21, 1481-1487
Full Text168
MARCO ZARDINI, RAYMOND YEE, RANJAN K. THAKUR, GEORGE J. KLEIN. (1994) Risk of Sudden Arrhythmic Death in the Wolff-Parkinson-White Syndrome: Current Perspectives. Pacing and Clinical Electrophysiology 17:5, 966-975
CrossRef169
ABRAHAM G. KOCHERIL, LYNDA E. ROSENFELD. (1994) Radiofrequency Ablation of an Accessory Pathway in a Patient with Corrected Ebstein's Anomaly. Pacing and Clinical Electrophysiology 17:5, 986-990
CrossRef170
Laurence M. Epstein, Nancy Chiesa, Marilynn Namekawa Wong, Randall J. Lee, Jerry C. Griffin, Melvin M. Scheinman, Michael D. Lesh. (1994) Radiofrequency catheter ablation in the treatment of supraventricular tachycardia in the elderly. Journal of the American College of Cardiology 23:6, 1356-1362
CrossRef171
Masahiro Nomura, Yutaka Nakaya, Ken Saito, Fumiko Kishi, Tetsuzo Watatsuki, Hirokazu Miyoshi, Akiyoshi Nishikado, Shigenobu Bando, Susumu Ito, Hiromu Nlshltanl, Masao Wada, Satoshi Fujita, Itsuro Tamura. (1994) Noninvasive localization of accessory pathways by magnetocardiographic imaging. Clinical Cardiology 17:5, 239-244
CrossRef172
DAVID E. HAINES, JAMES G. WHAYNE, JOHN P. DiMARCO. (1994) Intracoronary Ethanol Ablation in Swine:.. Journal of Cardiovascular Electrophysiology 5:5, 422-431
CrossRef173
VASSILIS SKEBERIS, FRANK SIMONIS, KALLINIKOS TSAKONAS, ALP AY CELIKER, ERIK ANDRIES, PEDRO BRUGADA. (1994) Inappropriate Sinus Tachycardia Following Radiofrequency Ablation of AV Nodal Tachycardia: Incidence and Clinical Significance. Pacing and Clinical Electrophysiology 17:5, 924-927
CrossRef174
MICHAEL D. LESH, GEORGE F. HARE. (1994) Status of Ablation in Patients with Atrial Tachycardia and Flutter. Pacing and Clinical Electrophysiology 17:5, 1026-1033
CrossRef175
Dwain L. Coggins, Randall J. Lee, John Sweeney, Walter W. Chein, George Van Hare, Laurence Epstein, Rolando Gonzalez, Jerry C. Griffin, Michael D. Lesh, Melvin M. Scheinman. (1994) Radiofrequency catheter ablation as a cure for idiopathic tachycardia of both left and eight ventricular origin. Journal of the American College of Cardiology 23:6, 1333-1341
CrossRef176
Roger S. Damle, Willie Choe, Nabil M. Kanaan, Frederick A. Ehlert, Jeffrey J. Goldberger, Alan H. Kadish. (1994) Atrial and accessory pathway activation direction in patients with orthodromic supraventricular tachycardia: Insights from vector mapping. Journal of the American College of Cardiology 23:3, 684-692
CrossRef177
SANJAY S. DESHPANDE, SIOBHAN BREMNER, JASBIR S. SRA, ANWER A. DHALA, ZALMEN BLANCK, TANVIR K. BAJWA, ISSAM AL-BITAR, RAMI GAL, JOSEPH S. SARNOSKI, MASOOD AKHTAR, MOHAMMAD R. JAZAYERI. (1994) Ablation of Left Free-Wall Accessory Pathways Using Radiofrequency Energy at the Atrial Insertion Site:.. Journal of Cardiovascular Electrophysiology 5:3, 219-231
CrossRef178
ANNE B. CURTIS, MICHAEL MANSOUR, STEPHAN E. FRIEDL, TAKANOBU TOMARU, GERALD R. BARBEAU, SIGURD J. NORMANN, GEORGE S. ABELA. (1994) Modification of Atrioventricular Conduction Using a Combined Laser-Electrode Catheter. Pacing and Clinical Electrophysiology 17:3, 337-348
CrossRef179
Richard Gorlin. (1994) Perspective on invasive cardiology: The 24th Louis F. Bishop lecture. Journal of the American College of Cardiology 23:2, 525-532
CrossRef180
TIMOTHY A. SIMMERS, RICHARD N.W. HAUER, ERIC E.D. WEVER, FRED H.M. WITTKAMPF, ETIENNE O. ROBLES MEDINA. (1994) Unipolar Electrogram Models for Prediction of Outcome in Radiofrequency Ablation of Accessory Pathways. Pacing and Clinical Electrophysiology 17:2, 186-198
CrossRef181
HUGH CALKINS, CHING MANN, STEVEN KALBFLEISCH, JONATHAN J. LANGBERG, FRED MORADY. (1994) Site of Accessory Pathway Block After Radiofrequency Catheter Ablation in Patients with the Wolff-Parkinson-White Syndrome. Journal of Cardiovascular Electrophysiology 5:1, 20-27
CrossRef182
Adam P. Fitzpatrick, Rolando P. Gonzales, Michael D. Lesh, Gunnard W. odin, Randall J. Lee, Melvin M. Scheinman. (1994) New algorithm for the localization of accessory atrioventricular connections using a baseline electrocardiogram. Journal of the American College of Cardiology 23:1, 107-116
CrossRef183
DAVID E. HAINES, ANTHONY F. VEROW, ALBERT J. SINUSAS, JAMES G. WHAYNE, JOHN P. DiMARCO. (1994) Intracoronary Ethanol Ablation in Swine:.. Journal of Cardiovascular Electrophysiology 5:1, 41-49
CrossRef184
AGUSTIN CASTELLANOS, ALBERTO INTERIAN, MARILYN M. COX, ROBERT J. MYERBURG. (1993) Alternating Wenckebach Periods and Allied Arrhythmias. Pacing and Clinical Electrophysiology 16:12, 2285-2300
CrossRef185
Huagui G. Li, George J. Klein, H.William Stites, Marco Zardini, Carlos A. Morillo, Ranjan K. Thakur, Raymond Yee. (1993) Elimination of slow pathway conduction: An accurate indicator of clinical success after radiofrequency atrioventricular node modification. Journal of the American College of Cardiology 22:7, 1849-1853
CrossRef186
Stephan Willems, Mohammad Shenasa, Martin Borggrefe, Gerhard Hindricks, Xu Chen, Brigitte Rotman, Hans Kottkamp, Wilhelm Haverkamp, GÜNter Breithardt. (1993) Atrioventricular nodal reentry tachycardia: Electrophysiologic comparisons in patients with and without 2:1 infra-his block. Clinical Cardiology 16:12, 883-888
CrossRef187
Ranjan K. Thakur, George J. Klein, Raymond Yee, H.William Stites. (1993) Junctional tachycardia: A useful marker during radiofrequency ablation for atrioventricular node reentrant tachycardia. Journal of the American College of Cardiology 22:6, 1706-1710
CrossRef188
SHIMON ROSENHECK, ZEHAVA SHARON, ALEXEY WEISS, YORAM AGMON, AVRAHAM T. WEISS, MERVYN S. GOTSMAN. (1993) Single Physician Approach to Radiofrequency Catheter Ahlation in Patients with Supraventricuiar Tachycardia. Pacing and Clinical Electrophysiology 16:11, 2112-2117
CrossRef189
MACDONALD DICK, PARVIN C. DOROSTKAR, GERALD SERWER, SARAH LEROY, BRIAN ARMSTRONG. (1993) Delayed Response to Radiofrequency Ablation of Accessory Connections. Pacing and Clinical Electrophysiology 16:11, 2143-2145
CrossRef190
MING-SHIEN WEN, SAN-JOU YEH, CHUN-CHIEH WANG, FUN-CHUNG LIN, DELON WU. (1993) Radiofrequency Ablation Therapy in Three Patients with Paroxysmal Atrial Tachycardia. Pacing and Clinical Electrophysiology 16:11, 2146-2156
CrossRef191
Jonathan J. Langberg, K.Ching Man, Vicken R. Vorperian, Brian Williamson, Steven J. Kalbfleisch, S.Adam Strickberger, John D. Hummel, Fred Morady. (1993) Recognition and catheter ablation of subepicardial accessory pathways. Journal of the American College of Cardiology 22:4, 1100-1104
CrossRef192
S. ADAM STRTCKBERGER, STEVEN J. KALBFLBISCH, BRIAN WILLIAMSON, K. CHING MAN, VICKEN VORPERIAN, JOHN D. HUMMEL, JONATHAN J. LANGBERG, FRED MORADY. (1993) Radiofrequency Catheter Ablation of AtypicalAtrioventricular Nodal Reentrant Tachycardia. Journal of Cardiovascular Electrophysiology 4:5, 526-532
CrossRef193
Kathy J. Jenkins, Edward P. Walsh, Steven D. Colan, Dennis M. Bergau, J.Philip Saul, James E. Lock. (1993) Multipolar endocardial mapping of the right atrium during cardiac catheterization: description of a new technique. Journal of the American College of Cardiology 22:4, 1105-1110
CrossRef194
Boaz Avitall, Miqdad Khan, David Krum, John Hare, Cynthia Lessila, Anwer Dhala, Sanjay Deshpande, Mohammad Jazayeri, Jasbir Sra, Masood Akhtar. (1993) Physics and engineering of transcatheter cardiac tissue ablation. Journal of the American College of Cardiology 22:3, 921-932
CrossRef195
Yau-Ting Tai, Chu-Pak Lau. (1993) Patterns of radiofrequency catheter ablation of left free-wall accessory pathways: Implications for accessory pathway anatomy. Clinical Cardiology 16:9, 644-652
CrossRef196
Bruce D. Lindsay, Mina K. Chung, M. Carolyn Gamache, Robert A. Luke, Kenneth B. Schechtman, Judy L. Osborn, Michael E. Cain. (1993) Therapeutic end points for the treatment of atrioventricular node reentrant tachycardia by catheter-guided radiofrequency current. Journal of the American College of Cardiology 22:3, 733-740
CrossRef197
George F. Van Hare, Michael D. Lesh, Paul Stanger. (1993) Radiofrequency catheter ablation of supraventricular arrhythmias in patients with congenital heart disease: Results and technical considerations. Journal of the American College of Cardiology 22:3, 883-890
CrossRef198
DAVID E. MANN, PATRICIA A. KELLY, STUART W. ADLER, CHARLES E. FUENZALIDA, MICHAEL J. REITER. (1993) Palpitations Occur Frequently Following Radiofrequency Catheter Ablation for Supraventricular Tachycardia, But Do Not Predict Pathway Recurrence. Pacing and Clinical Electrophysiology 16:8, 1645-1649
CrossRef199
G. NEAL KAY, ANDREW E. EPSTEIN, SHARON M. DAILEY, VANCE J. PLUMB. (1993) Role of Radiofrequency Ablation in the Management of Supraventricular Arrhythmias:.. Journal of Cardiovascular Electrophysiology 4:4, 371-392
CrossRef200
Yaver Bashir, Spencer C. Heald, Sean O'nunain, Demosthenes Katritsis, A.John Camm, David E. Ward. (1993) Radiofrequency current delivery by way of a bipolar tricuspid annuls-mitral annulus electrode configuration for ablation of posteroseptal accessory pathways. Journal of the American College of Cardiology 22:2, 550-556
CrossRef201
Michael D. Lesh, George F. Van Hare, Melvin M. Scheinman, Thomas A. Ports, Lawrence A. Epstein. (1993) Comparison of the retrograde and transseptal methods for ablation of left free wall accessory pathways. Journal of the American College of Cardiology 22:2, 542-549
CrossRef202
JOSEPH M. SMITH, MICHAEL E. CAIN. (1993) Radiofrequency Catheter Ablation for Supra ventricular Tachycardias:.. Journal of Cardiovascular Electrophysiology 4:4, 390-392
CrossRef203
D. L. ROSS. (1993) Radiofrequency catheter ablation for supraventricular tachycardias. Australian and New Zealand Journal of Medicine 23:4, 339-342
CrossRef204
Thomas G. Bartlett, Peter L. Friedman. (1993) Current Management of the Wolff-Parkinson-White Syndrome. Journal of Cardiac Surgery 8:4, 503-515
CrossRef205
YANZONG YANG, CESARE GRECO, ANTONIO CICCAGLIONI, RAFFAELE QUAGLIONE, GIUSEPPE CRITELLI. (1993) Curative Radiofrequency Catheter Ablation for Permanent Junctional Reciprocating Tachycardia. Pacing and Clinical Electrophysiology 16:7, 1373-1379
CrossRef206
ANGAS W.F. HAMER, NEIL STRATHMORE, JITU K. VOHRA, V. DAVID HUNT. (1993) Oral Flecainide, Sotalol, and Verapamil for the Termination of Paroxysmal Supraventricular Tachycardia. Pacing and Clinical Electrophysiology 16:7, 1394-1400
CrossRef207
Nelson A. Prager, James L. Cox, Bruce D. Lindsay, T.Bruce Ferguson, Judy L. Osborn, Michael E. Cain. (1993) Long-term effectiveness of surgical treatment of ectopic atrial tachycardia. Journal of the American College of Cardiology 22:1, 85-92
CrossRef208
CHRISTOPHER L. CASE, MICHAEL S. SCHAFFER, ANWER A. DHALA, PAUL C. GILLETTE, SCOTT E. FLETCHER. (1993) Radiofrequency Catheter Ablation of an Accessory Atrioventricular Connection in a Fontan Patient. Pacing and Clinical Electrophysiology 16:7, 1434-1436
CrossRef209
Delon Wu, San-Jou Yeh, Chun-Chieh Wang, Ming-Shien Wen, Fun-Chung Lin. (1993) A simple technique for selective radiofrequency ablation of the slow pathway in atrioventricular node reentrant tachycardia. Journal of the American College of Cardiology 21:7, 1612-1621
CrossRef210
NICHOLAS TWIDALE, KAYE SUTTON, LYN BARTLETT, ALISON DOOLEY, SUSAN WINSTANLEY, WILLIAM HEDDLE, RHONDA HASSAM, HARI KOUTSOUNIS. (1993) Effects on Cardiac Performance of Atrioventricular Node Catheter Ablation Using Radiofrequency Current for Drug-Refractory Atrial Arrhythmias. Pacing and Clinical Electrophysiology 16:6, 1275-1284
CrossRef211
ALAN H. KADISH, FRED MORADY. (1993) The Response of Paroxysmal Supraventricular Tachycardia to Overdrive Atrial and Ventricular Pacing:.. Journal of Cardiovascular Electrophysiology 4:3, 239-252
CrossRef212
Karl-Heinz Kuck, Michael Schlüter. (1993) Junctional tachycardia and the role of catheter ablation. The Lancet 341:8857, 1386-1392
CrossRef213
JONATHAN J. LANGBERG, S. MARK BORGANELLI, STEVEN J. KALBFLEISCH, S. ADAM STRIGKBERGER, HUGH GALKINS, FRED MORADY. (1993) Delayed Effects of Radiofrequency Energy on Accessory Atrioventricular Connections. Pacing and Clinical Electrophysiology 16:5, 1001-1005
CrossRef214
Allen J. Solomon, Cynthia M. Tracy, John F. Swartz, Kathleen M. Reagan, Pamela E. Karasik, Ross D. Fletcher. (1993) Effect on coronary artery anatomy of radiofrequency catheter ablation of atrial insertion sites of accessory pathways. Journal of the American College of Cardiology 21:6, 1440-1444
CrossRef215
ANDREA NATALE, MARK WATHEN, KEVIN WOLFE, RAYMOND YEE, GERARD M. GUIRAUDON, GEORGE J. KLEIN. (1993) Comparative Atrioventricular Node Properties After Radiofrequency Ablation and Operative Therapy of Atrioventricular Node Reentry. Pacing and Clinical Electrophysiology 16:5, 971-977
CrossRef216
KENNETH M. STEIN, BRUCE B. LERMAN. (1993) Delayed Success Following Radiofrequency Catheter Ablation. Pacing and Clinical Electrophysiology 16:4, 698-701
CrossRef217
David A. Ott, Denton A. Cooley, Jeffrey Moak, Richard A. Friedman, James Perry, Arthur Garson. (1993) Computer-guided surgery for tacfayarrhythmias in children: Current results and expectations. Journal of the American College of Cardiology 21:5, 1205-1210
CrossRef218
SINAN GÜRSOY, MICHAEL SCHLÜTER, KARL-HEINZ KUCK. (1993) Radiofrequency Current Catheter Ablation for Control of Supraventricular Arrhythmias. Journal of Cardiovascular Electrophysiology 4:2, 194-205
CrossRef219
DIETRICH ANDRESEN, STEFFEN BEHRENS, THOMAS BRUGGEMANN, ROLF SCHRODER. (1993) Should Radiofrequency Therapy Be Performed in Every Symptomatic Patient with Supraventricular Tachycardia? (Pro Drug Position). Pacing and Clinical Electrophysiology 16:3, 653-657
CrossRef220
WOLFGANG DUGKEGK, ERICA D. ENGELSTEIN, KARL-HEINZ KUCK. (1993) Radiofrequency Current Therapy in Atrial Tachyarrhythmias: Modulation Versus Ablation of Atrioventricular Nodal Conduction. Pacing and Clinical Electrophysiology 16:3, 629-636
CrossRef221
MICHAEL SCHLUTER, KARL-HEINZ KUCK. (1993) Radiofrequency Current Therapy of Supraventricular Tachycardia: Accessory Atrioventricular Pathways. Pacing and Clinical Electrophysiology 16:3, 643-648
CrossRef222
J.Philip Saul, J.Edward Hulse, Wang De, Allison T. Weber, Larry A. Rhodes, James E. Lock, Edward P. Walsh. (1993) Catheter ablation of accessory atrioventricular pathways in young patients: Use of long vascular sheaths, the transseptal approach and a retrograde left posterior parallel approach. Journal of the American College of Cardiology 21:3, 571-583
CrossRef223
G.Neal Kay, Felipe Chong, Andrew E. Epstein, Sharon M. Dailey, Vance J. Plumb. (1993) Radiofrequency ablation for treatment of primary atrial tachycardias. Journal of the American College of Cardiology 21:4, 901-909
CrossRef224
Steven J. Kalbfleisch, Rafel El-Atassi, Hugh Calkins, Jonathan J. Langberg, Fred Morady. (1993) Safety, feasibility and cost of outpatient radiofrequency catheter ablation of accessory atrioventricular connections. Journal of the American College of Cardiology 21:3, 567-570
CrossRef225
Cynthia M. Tracy, John F. Swartz, Ross D. Fletcher, Harry G. Hoops, Allen J. Solomon, Pamela E. Karasik, Diane Mukherjee. (1993) Radiofrequency catheter ablation of ectopic atrial tachycardia using paced activation sequence mapping. Journal of the American College of Cardiology 21:4, 910-917
CrossRef226
GERHARD STEINBECK. (1993) Should Radiofrequency Current Ablation be Performed in Asymptomatic Patients with the Wolff-Parkinson-White Syndrome?. Pacing and Clinical Electrophysiology 16:3, 649-652
CrossRef227
DAVID E. HAINES. (1993) The Biophysics of Radiofrequency Catheter Ablation in the Heart: The Importance of Temperature Monitoring. Pacing and Clinical Electrophysiology 16:3, 586-591
CrossRef228
JONATHAN J. LANGBERG, MARK HARVEY, HUGH CALKINS, RAFEL EL-ATASSI, STEVEN J. KALBELEISGH, FRED MORADY. (1993) Titration of Power Output During Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia. Pacing and Clinical Electrophysiology 16:3, 465-470
CrossRef229
Raul D. Mitrani, Lawrence S. Klein, F.Kevin Hackett, Douglas P. Zipes, William M. Miles. (1993) Radiofrequency ablation for atrioventricular node reentrant tachycardia: Comparison between fast (anterior) and slow (posterior) pathway ablation. Journal of the American College of Cardiology 21:2, 432-441
CrossRef230
RICHARD L. PAGE, HOSSEIN SHENASA, JOSEPH J. EVANS, ROBERT A. SORRENTINO, J. MARCUS WHARTON, ERIC N. PRYSTOWSKY. (1993) Radiofrequency Catheter Ablation of Idiopathic Recurrent Ventricular Tachycardia with Right Bundle Branch Block, Left Axis Morphology. Pacing and Clinical Electrophysiology 16:2, 327-336
CrossRef231
KAREN S. ROVANG, TOM T. HEE, TOM V. PAGANO, SYED MOHIUDDIN. (1993) Dressler's Syndrome Complicating Radiofrequency Ablation of an Accessory Atrioventricular Pathway. Pacing and Clinical Electrophysiology 16:2, 251-253
CrossRef232
CHERN-EN CHIANG, SHIH-ANN CHEN, WING-PING TSANG, CHIH-PING HSIA, DER-CHIN WANG, CHEUEN-WONG CHIOU, CHIN-RUEY YANG, SHIH-PU WANG, BENJAMIN N. CHIANG, MAU-SONG CHANG. (1993) Radiofrequency Ablation of Left-Sided Accessory Atrioventricular Pathways in Patients with Unusual Coronary Sinus. Pacing and Clinical Electrophysiology 16:1, 62-69
CrossRef233
WESTBY G. FISHER, JOHN F. SWARTZ. (1992) Three-Dimensional Electrogram Mapping Improves Ablation of Left-Sided Accessory Pathways. Pacing and Clinical Electrophysiology 15:12, 2344-2356
CrossRef234
Adrian H. Shandling, Randy Crump, Maria Nolasco, Linda M. Lorenz, Curtis K. Li. (1992) The effect of chronic atrial overdrive suppression pacing on the incidence of supraventricular tachyarrhythmias. Clinical Cardiology 15:12, 917-922
CrossRef235
P. ADRAGAO, S. EVANS, T. IWA, J. TONET, R. FRANK, G. FONTAINE. (1992) Factors Predicting Success in DC Catheter Ablation of Accessory Pathways. Pacing and Clinical Electrophysiology 15:11, 1750-1759
CrossRef236
M. HAISSAGUERRE, B. FISCHER, J.-F. WARIN, J.F. DARTIGUES, Ph. LEMETAYER, Ph. EGLOFF. (1992) Electrogram Patterns Predictive of Successful Radiofrequency Catheter Ablation of Accessory Pathways. Pacing and Clinical Electrophysiology 15:11, 2138-2145
CrossRef237
Christopher L. Case, Paul C. Gillette, Paul C. Oslizlok, Barbara J. Knick, Henry L. Blair. (1992) Radiofrequency catheter ablation of incessant, medically resistant supraventricular tachycardia in infants and small children. Journal of the American College of Cardiology 20:6, 1405-1410
CrossRef238
Michael D. Sharpe, Wojciech B. Dobkowski, John M. Murkin, George Klein, Gerard Guiraudon, Raymond Yee. (1992) Alfentanil-midazolam anaesthesia has no electrophysiological effects upon the normal conduction system or accessory pathways in patients with Wolff-Parkinson-White syndrome. Canadian Journal of Anaesthesia 39:8, 816-821
CrossRef239
SHIH-ANN CHEN, CHERN-EN CHIANG, CHUEN-WANG CHIOU, SHIH-PU WANG, BENJAMIN N. CHIANG, MAU-SONG CHANG. (1992) Radiofrequency Ablation of Bilateral Quadruple Accessory Pathways in a Patient with Wolff-Parkinson-White Syndrome. Pacing and Clinical Electrophysiology 15:9, 1266-1278
CrossRef240
MELVIN M. SCHEINMAN, MASOOD AKHTAR, LEONARD DREIFUS, G. THOMAS EVANS, PAUL GILLETTE, S.K. STEPHEN HUANG, WARREN JACKMAN, JONATHAN J. LANGBERG, JAMES MALONEY, FRED MORADY, JEREMY RUSKIN, SANJEEV SAKSENA, AL WALDO, DOUGLAS ZIPES. (1992) Catheter Ablation for Cardiac Arrhythmias, Personnel, and Facilities. Journal of Interventional Cardiology 5:3, 219-226
CrossRef241
XU Chen, Martin Borggrefe, Mohammad Shenasa, Wilhelm Haverkamp, Gerhard Hindricks, Günter Breithardt. (1992) Characteristics of local electrogram predicting successful transcatheter radiofrequency ablation of left-sided accessory pathways. Journal of the American College of Cardiology 20:3, 656-665
CrossRef242
MICHAEL D. LESH, DWAIN L. COGGINS, THOMAS A. PORTS. (1992) Coronary Air Embolism Complicating Transseptal Radiofrequency Ablation of Left Free-Wall Accessory Pathways. Pacing and Clinical Electrophysiology 15:8, 1105-1108
CrossRef243
XU CHEN, MARTIN BORGGREFE, GERHARD HINDRICKS., WILHELM HAVERKAMP, ULRICH KARBENN, MOHAMMAD SHENASA., GUNTER BREITHARDT. (1992) Radiofrequency Ablation of Accessory Pathways: Characteristics of Transiently and Permanently Effective Pulses. Pacing and Clinical Electrophysiology 15:8, 1122-1130
CrossRef244
Jackman, Warren M., Beckman, Karen J., McClelland, James H., Wang, Xunzhang, Friday, Karen J., Roman, Carlos A., Moulton, Kriegh P., Twidale, Nicholas, Hazlitt, H. Andrew, Prior, Michael I., Oren, Jess, Overholt, Edward D., Lazzara, Ralph, . (1992) Treatment of Supraventricular Tachycardia Due to Atrioventricular Nodal Reentry by Radiofrequency Catheter Ablation of Slow-Pathway Conduction. New England Journal of Medicine 327:5, 313-318
Full Text245
MICHAEL J. SILKA, JACK KRON, BLAIR D. HALPERIN, KAREN GRIFFITH, BRIAN CRANDALL, RONALD P. OLIVER, CHARLES G. WALANCE, JOHN H. MCANULTY. (1992) Analysis of Local Electrogram Characteristics Correlated with Successful Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways. Pacing and Clinical Electrophysiology 15:7, 1000-1007
CrossRef246
DAVID E. HAINES. (1992) Thermal Ablation of Perfused Porcine Left Ventricle In Vitro with the Neodymium-YAG Laser Hot Tip Catheter System. Pacing and Clinical Electrophysiology 15:7, 979-985
CrossRef247
Jonathan J. Langberg, Hugh Calkins, Youn-Nyun Kim, João Sousa, Rafel El-Atassi, Angel Leon, Mark Borganelli, Steven J. Kalbfleisch, Fred Morady. (1992) Recurrence of conduction in accessory atrioventricular connections after initially successful radiofrequency catheter ablation. Journal of the American College of Cardiology 19:7, 1588-1592
CrossRef248
Steven J. Kalbfleisch, Hugh Calkins, Jonathan J. Langberg, Rafel El-Atassi, Angel Leon, Mark Borganelli, Fred Morady. (1992) Comparison of the cost of radiofrequency catheter modification of the atrioventricular node and medical therapy for drug-refractory atrioventricular node reentrant tachycardia. Journal of the American College of Cardiology 19:7, 1583-1587
CrossRef249
Wood, Alastair J.J., , Pritchett, Edward L.C., . (1992) Management of Atrial Fibrillation. New England Journal of Medicine 326:19, 1264-1271
Full Text250
Michael D. Lesh, George F. Van Hare, David J. Schamp, Walter Chien, Michael A. Lee, Jerry C. Griffin, Jonathan J. Langberg, Todd J. Cohen, Keith G. Lurie, Melvin M. Scheinman. (1992) Curative percutaneous catheter ablation using radiofrequency energy for accessory pathways in all locations: Results in 100 consecutive patients. Journal of the American College of Cardiology 19:6, 1303-1309
CrossRef251
MICHAEL E. CAIN, ROBERT A. LUKE, BRUCE D. LINDSAY. (1992) Diagnosis and Localization of Accessory Pathways. Pacing and Clinical Electrophysiology 15:5, 801-824
CrossRef252
MELVIN M. SCHEINMAN. (1992) Catheter Ablation for Cardiac Arrhythmias, Personnel, and Facilities. Pacing and Clinical Electrophysiology 15:5, 715-721
CrossRef253
SINAN GURSOY, JOSEP BRUGADA, OLGA SOUZA, GUNTER STEURER, ERIK ANDRIES, PEDRO BRUGADA. (1992) Radiofrequency Ablation of Symptomatic but Benign Ventricular Arrhythmias. Pacing and Clinical Electrophysiology 15:5, 738-741
CrossRef254
LUZ MARIA ODRIGUEZ, JOEP L.M SMEETS, JÜRG SCHLÄPFER, APOSTOLOS KATSIVAS, BARBARA DIJKMAN, CHRISTIAN DE HILLOU, OTTO M. ORNING, HEIN J.J. WELLENS. (1992) Radiofrequency Catheter Ablation of Three Accessory Pathways in a Single Session. Journal of Cardiovascular Electrophysiology 3:2, 141-149
CrossRef255
STEVEN J. KALBFLEISCH, JONATHAN J. LANGBERG. (1992) Catheter Ablation with Radiofrequency Energy: Biophysical Aspects and Clinical Applications. Journal of Cardiovascular Electrophysiology 3:2, 173-186
CrossRef256
Michael Schlüter, Karl-Heinz Kuck. (1992) Catheter ablation from right atrium of anteroseptal accessory pathways using radiofrequency current. Journal of the American College of Cardiology 19:3, 663-670
CrossRef257
P. E. Bloch Thomsen, P. K. Paulsen, O. Kromann, H. R. Andersen, A. K. Pedersen, H. Allermand, P. Mortensen, L. Frost, O. Albrechtsen. (1992) Nonpharmacologic Treatment of Supraventricular and Ventricular Tachyarrhythmias: A Review of 249 Consecutive Patients. Scandinavian Cardiovascular Journal 26:3, 197-205
CrossRef258
MARK HARVEY, YOON-NYUN KIM, JOAO SOUSA, RAFEL EL-ATASSI, FRED MORADY, HUGH CALKINS, JONATHAN J. LANGBERG. (1992) Impedance Monitoring During Radiofrequency Catheter Ablation in Humans. Pacing and Clinical Electrophysiology 15:1, 22-27
CrossRef259
Pablo Denes. (1991) Radiofrequency catheter ablation of the AV node. Journal of the American College of Cardiology 18:7, 1759-1760
CrossRef260
JONATHAN J. LANGBERG, TRACY WONNELL, MICHAEL C. CHIN, WALTER FINKBEINER, MELVIN SCHEINMAN, PAUL STAUFFER. (1991) Catheter Ablation of the Atrioventricular Junction Using a Helical Microwave Antenna: A Novel Means of Coupling Energy to the Endocardium. Pacing and Clinical Electrophysiology 14:12, 2105-2113
CrossRef261
Ruskin, Jeremy N., . (1991) Catheter Ablation for Supraventricular Tachycardia. New England Journal of Medicine 324:23, 1660-1662
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