Radiofrequency Catheter Ablation

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Contents 1 More Specific Terms 2 Indications 3 Complications 4 Notes 5 More General Terms 6 References

More Specific Terms

• circumferential catheter-based ablation of pulmonary veins
• pulmonary vein isolation; pulmonary vein ablation; pulmonary vein antrum isolation

Indications

• AV nodal re-entrant tachycardia (97%)*
• orthodromic AV reciprocating tachycardia in involving a manifested or concealed pathway (97%)*
• sustained unifocal atrial tachycardia
• AV nodal ablation to create complete heart block in patients with uncontrolled ventricular response to atrial fibrillation (100%)*
• atrial flutter (90%)*
• atrial fibrillation (66%) [2,5] (see pulmonary vein isolation)
• ventricular arrhythmias

• ventricular tachycardia in the absence of structural heart disease
• ventricular tachycardia involving the conduction system ( bundle branch re-entry)

• * success rate

Complications

• stroke during procedure (1%) [5]
• cardiac tamponade requiring pericardiocentesis
• mortality is 1 in 1000 patients or 1 in 1385 procedures [3]

Notes

• Limitations:

• need for hemodynamic stability to allow for accurate mapping of conduction abnormalities
• of limited use in the setting of coronary artery disease

More General Terms

• cardiology
• radioablation (photodynamic ablation)

References

1. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
2. Journal Watch 25(3):22-23, 2005 Hsu LF, Jais P, Sanders P, Garrigue S, Hocini M, Sacher F, Takahashi Y, Rotter M, Pasquie JL, Scavee C, Bordachar P, Clementy J, Haissaguerre M. Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med. 2004 Dec 2;351(23):2373-83. PMID: [1]
3. Cappato R et al Prevalence and causes of fatal outcome in catheter ablation of atrial fibrillation. J Am Coll Cardiol 2009 May 12; 53:1798. PMID: [2]
   - Belhassen B. A 1 per 1,000 mortality rate after catheter ablation of atrial fibrillation: An acceptable risk? J Am Coll Cardiol 2009 May 12; 53:1804. PMID: [3]
4. Terasawa T et al Systematic review: Comparative effectiveness of radiofrequency catheter ablation for atrial fibrillation. Ann Intern Med 2009 Aug 4; 151:191. PMID: [4]
5. Wilber DJ et al Comparison of Antiarrhythmic Drug Therapy and Radiofrequency Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation. JAMA. 2010;303(4):333-340. <PubMed> PMID: [5] <Internet> [6]

radiofrequency catheter ablation