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Article
Ablation of left free-wall accessory pathways using radiofrequency energy at the atrial insertion site: transseptal versus transaortic approach
Journal of cardiovascular electrophysiology
  • Sanjay S Deshpande, Aurora Health Care
  • Siobhan Bremner, Aurora Health Care
  • Jasbir Sra, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care
  • Anwer Dhala, Aurora Health Care
  • Zalmen Blanck, Aurora Health Care
  • Tanvir Bajwa, Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke’s Medical Centers, University of Wisconsin School of Medicine and Public Health
  • Issam Al-Bitar, Aurora Health Care
  • Abraham Gal, Aurora Health Care
  • Joseph S Sarnoski, Aurora Health Care
  • Masood Akhtar, Aurora Sinai/Aurora St. Luke’s Medical Centers, Aurora Health Care
Aurora Affiliations

Electrophysiology Laboratory, Sinai Samaritan Medical Center-Mount Sinai Campus

Publication Date
3-1-1994
Abstract
INTRODUCTION: Transcatheter ablation of the left free-wall atrioventricular accessory pathways (AP) by delivery of radiofrequency current at the ventricular insertion site has been shown to be effective. The efficacy of such a technique targeting the atrial insertion site of the AP was evaluated. METHODS AND RESULTS: One hundred consecutive patients with left free-wall APs and symptomatic supraventricular tachyarrhythmias were included. APs were manifest in 55 patients and concealed in 45. There were 55 men and 45 women with a mean age of 35 years. A total of 107 left free-wall APs were identified in these patients. In these 100 patients, successful ablation was accomplished in all by using a transseptal (45 patients) or transaortic (54 patients) technique. In one patient, ablation was accomplished from within the coronary sinus. Seven patients required a repeat ablative procedure, which was performed successfully. During 107 ablative procedures, six were associated with nonfatal complications including pericardial effusion (hemopericardium) in two patients, mild mitral regurgitation in two patients, swelling of the left arm in one patient, and staphylococcal bacteremia in one patient. Eighty-two (82%) patients underwent a repeat electrophysiologic study 6 to 8 weeks after successful ablation and were found to have no functioning AP or inducible supraventricular tachycardia. During a mean follow-up of 20 +/- 8 months, none of the 100 patients had a recurrence of tachyarrhythmias. CONCLUSION: These data indicate that the atrial insertion site of the AP can be successfully ablated in the majority of patients with left free-wall APs by using either a transseptal or transaortic approach. Furthermore, both techniques are associated with minimal morbidity and no mortality.
Document Type
Article
PubMed ID
8193738
Citation Information
Deshpande SS, Bremner S, Sra JS, et al. Ablation of left free-wall accessory pathways using radiofrequency energy at the atrial insertion site: transseptal versus transaortic approach. J Cardiovasc Electrophysiol. 1994 Mar;5(3):219-31.