P1012Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery

P1012Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery

Abstract Background Radiofrequency catheter ablation (RFCA) for accessory pathways (APs) at the site of prior valve surgery remains challenging. We aimed to clarify the factors associated with successful RFCA for such APs. Methods Upon reviewing a RFCA registry and previous case reports, we included...

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Veröffentlicht in:European heart journal 2019-10, Vol.40 (Supplement_1)
Hauptverfasser: Uhm, J S, Kim, J, Jin, M N, Kim, I S, Bae, H J, Cho, M S, Yu, H T, Kim, T H, Joung, B, Pak, H N, Nam, G B, Choi, K J, Kim, Y H, Lee, M H
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container_issue Supplement_1
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container_title European heart journal
container_volume 40
creator Uhm, J S
Kim, J
Jin, M N
Kim, I S
Bae, H J
Cho, M S
Yu, H T
Kim, T H
Joung, B
Pak, H N
Nam, G B
Choi, K J
Kim, Y H
Lee, M H
description Abstract Background Radiofrequency catheter ablation (RFCA) for accessory pathways (APs) at the site of prior valve surgery remains challenging. We aimed to clarify the factors associated with successful RFCA for such APs. Methods Upon reviewing a RFCA registry and previous case reports, we included nine patients who underwent RFCA of APs at the site of prior valve surgery (total-VS group; age, 34.0 [24.5–45.0] years; men, 4/9) and 196 patients who underwent RFCA of APs with no history of valve surgery (no-VS group; age, 40.5 [23.0–54.0] years; men, 114/196). Electrophysiological features, procedural details, and outcomes were examined. Results AP exhibited decremental conduction in four of nine patients in the total-VS group. The number of RFCA attempts was significantly higher in the total-VS group than in the no-VS group (10.0 [4.5–14.5] vs 2.0 [1.0–3.0]; p
doi_str_mv 10.1093/eurheartj/ehz747.0604
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We aimed to clarify the factors associated with successful RFCA for such APs. Methods Upon reviewing a RFCA registry and previous case reports, we included nine patients who underwent RFCA of APs at the site of prior valve surgery (total-VS group; age, 34.0 [24.5–45.0] years; men, 4/9) and 196 patients who underwent RFCA of APs with no history of valve surgery (no-VS group; age, 40.5 [23.0–54.0] years; men, 114/196). Electrophysiological features, procedural details, and outcomes were examined. Results AP exhibited decremental conduction in four of nine patients in the total-VS group. The number of RFCA attempts was significantly higher in the total-VS group than in the no-VS group (10.0 [4.5–14.5] vs 2.0 [1.0–3.0]; p&lt;0.001). In four patients who underwent mitral valve surgery, successful RFCA was achieved using the transaortic approach, coronary sinus approach, or bipolar ablation. In three patients who underwent tricuspid valve surgery, successful RFCA was achieved using the above-prosthetics or trans-prosthetics approach. In two patients, RFCA failed. The trans-prosthetics approach and bipolar ablation technique were effective. The transaortic and coronary sinus approaches were occasionally effective. The transseptal approach was ineffective. Based on the success rate and accessibility, we suggest a stepwise approach to RFCA of APs at the site of prior mitral or tricuspid valve surgery (Figure). Stepwise approach to AP at valve surgery Conclusions Successful RFCA of APs at the site of prior valve surgery can be achieved by detailed mapping of the areas both above and below the prosthetic valve, as well as by ensuring effective radiofrequency energy delivery using various catheter approaches and RFCA techniques.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz747.0604</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids></links><search><creatorcontrib>Uhm, J S</creatorcontrib><creatorcontrib>Kim, J</creatorcontrib><creatorcontrib>Jin, M N</creatorcontrib><creatorcontrib>Kim, I S</creatorcontrib><creatorcontrib>Bae, H J</creatorcontrib><creatorcontrib>Cho, M S</creatorcontrib><creatorcontrib>Yu, H T</creatorcontrib><creatorcontrib>Kim, T H</creatorcontrib><creatorcontrib>Joung, B</creatorcontrib><creatorcontrib>Pak, H N</creatorcontrib><creatorcontrib>Nam, G B</creatorcontrib><creatorcontrib>Choi, K J</creatorcontrib><creatorcontrib>Kim, Y H</creatorcontrib><creatorcontrib>Lee, M H</creatorcontrib><title>P1012Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery</title><title>European heart journal</title><description>Abstract Background Radiofrequency catheter ablation (RFCA) for accessory pathways (APs) at the site of prior valve surgery remains challenging. We aimed to clarify the factors associated with successful RFCA for such APs. Methods Upon reviewing a RFCA registry and previous case reports, we included nine patients who underwent RFCA of APs at the site of prior valve surgery (total-VS group; age, 34.0 [24.5–45.0] years; men, 4/9) and 196 patients who underwent RFCA of APs with no history of valve surgery (no-VS group; age, 40.5 [23.0–54.0] years; men, 114/196). Electrophysiological features, procedural details, and outcomes were examined. Results AP exhibited decremental conduction in four of nine patients in the total-VS group. The number of RFCA attempts was significantly higher in the total-VS group than in the no-VS group (10.0 [4.5–14.5] vs 2.0 [1.0–3.0]; p&lt;0.001). In four patients who underwent mitral valve surgery, successful RFCA was achieved using the transaortic approach, coronary sinus approach, or bipolar ablation. In three patients who underwent tricuspid valve surgery, successful RFCA was achieved using the above-prosthetics or trans-prosthetics approach. In two patients, RFCA failed. The trans-prosthetics approach and bipolar ablation technique were effective. The transaortic and coronary sinus approaches were occasionally effective. The transseptal approach was ineffective. Based on the success rate and accessibility, we suggest a stepwise approach to RFCA of APs at the site of prior mitral or tricuspid valve surgery (Figure). Stepwise approach to AP at valve surgery Conclusions Successful RFCA of APs at the site of prior valve surgery can be achieved by detailed mapping of the areas both above and below the prosthetic valve, as well as by ensuring effective radiofrequency energy delivery using various catheter approaches and RFCA techniques.</description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkN1Kw0AQRhdRMFYfQdgXSLuz3Wyyl1L8g4IivfDKMNnMmpTarbtJJT69KRWvvRr45jvDcBi7BjEFYeYz6kNDGLr1jJrvXOVToYU6YQlkUqZGq-yUJQJMlmpdvJ6zixjXQohCg07Y2zMIkC9Yt94F-uxpawdusWuoo8Cx2mDX-i33jqO1FKMPA9-N6y8cIseOj0Ue244OjV1ofeB73OzHrA_vFIZLduZwE-nqd07Y6u52tXhIl0_3j4ubZWqLXKUuA2eg0E4TENZa29qoHE2lgBwpIlWAhAxlRcqBI-kqmWvIEUShDIr5hGXHszb4GAO5cvzlA8NQgigPjso_R-XRUXlwNHLiyPl-90_kB1MncM8</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Uhm, J S</creator><creator>Kim, J</creator><creator>Jin, M N</creator><creator>Kim, I S</creator><creator>Bae, H J</creator><creator>Cho, M S</creator><creator>Yu, H T</creator><creator>Kim, T H</creator><creator>Joung, B</creator><creator>Pak, H N</creator><creator>Nam, G B</creator><creator>Choi, K J</creator><creator>Kim, Y H</creator><creator>Lee, M H</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P1012Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery</title><author>Uhm, J S ; Kim, J ; Jin, M N ; Kim, I S ; Bae, H J ; Cho, M S ; Yu, H T ; Kim, T H ; Joung, B ; Pak, H N ; Nam, G B ; Choi, K J ; Kim, Y H ; Lee, M H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c874-f51f9186f6e1ead66cd947a9b41efe4ee481215a2be4f1fe2fb27617a10849a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uhm, J S</creatorcontrib><creatorcontrib>Kim, J</creatorcontrib><creatorcontrib>Jin, M N</creatorcontrib><creatorcontrib>Kim, I S</creatorcontrib><creatorcontrib>Bae, H J</creatorcontrib><creatorcontrib>Cho, M S</creatorcontrib><creatorcontrib>Yu, H T</creatorcontrib><creatorcontrib>Kim, T H</creatorcontrib><creatorcontrib>Joung, B</creatorcontrib><creatorcontrib>Pak, H N</creatorcontrib><creatorcontrib>Nam, G B</creatorcontrib><creatorcontrib>Choi, K J</creatorcontrib><creatorcontrib>Kim, Y H</creatorcontrib><creatorcontrib>Lee, M H</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uhm, J S</au><au>Kim, J</au><au>Jin, M N</au><au>Kim, I S</au><au>Bae, H J</au><au>Cho, M S</au><au>Yu, H T</au><au>Kim, T H</au><au>Joung, B</au><au>Pak, H N</au><au>Nam, G B</au><au>Choi, K J</au><au>Kim, Y H</au><au>Lee, M H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P1012Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract>Abstract Background Radiofrequency catheter ablation (RFCA) for accessory pathways (APs) at the site of prior valve surgery remains challenging. We aimed to clarify the factors associated with successful RFCA for such APs. Methods Upon reviewing a RFCA registry and previous case reports, we included nine patients who underwent RFCA of APs at the site of prior valve surgery (total-VS group; age, 34.0 [24.5–45.0] years; men, 4/9) and 196 patients who underwent RFCA of APs with no history of valve surgery (no-VS group; age, 40.5 [23.0–54.0] years; men, 114/196). Electrophysiological features, procedural details, and outcomes were examined. Results AP exhibited decremental conduction in four of nine patients in the total-VS group. The number of RFCA attempts was significantly higher in the total-VS group than in the no-VS group (10.0 [4.5–14.5] vs 2.0 [1.0–3.0]; p&lt;0.001). In four patients who underwent mitral valve surgery, successful RFCA was achieved using the transaortic approach, coronary sinus approach, or bipolar ablation. In three patients who underwent tricuspid valve surgery, successful RFCA was achieved using the above-prosthetics or trans-prosthetics approach. In two patients, RFCA failed. The trans-prosthetics approach and bipolar ablation technique were effective. The transaortic and coronary sinus approaches were occasionally effective. The transseptal approach was ineffective. Based on the success rate and accessibility, we suggest a stepwise approach to RFCA of APs at the site of prior mitral or tricuspid valve surgery (Figure). Stepwise approach to AP at valve surgery Conclusions Successful RFCA of APs at the site of prior valve surgery can be achieved by detailed mapping of the areas both above and below the prosthetic valve, as well as by ensuring effective radiofrequency energy delivery using various catheter approaches and RFCA techniques.</abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz747.0604</doi></addata></record>
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title P1012Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery
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