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Electrical ablation of posteroseptal accessory pathways.
J Vohra1, N Strathmore, P Kertes
1Department of Cardiology, Royal Melbourne Hospital, Vic., Australia.
Australian and New Zealand Journal of Medicine
|April 1, 1990
Summary
Electrical ablation for posteroseptal accessory pathways showed limited success, with only one patient fully treated. The procedure carries significant risks, including coronary sinus perforation, making surgery the preferred curative option.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Posteroseptal accessory pathways can cause significant arrhythmias.
- Current ablation techniques for these pathways have varying success rates and risks.
Purpose of the Study:
- To evaluate the efficacy and safety of direct current electrical ablation for posteroseptal accessory pathways.
- To compare electrical ablation with existing treatment options for these arrhythmias.
Main Methods:
- Twelve direct current electrical ablation procedures were performed on six patients with posteroseptal accessory pathways.
- The ablation target was the coronary sinus ostium.
Main Results:
- Successful ablation of the posteroseptal accessory pathway occurred in only one of six patients.
- Retrograde conduction was affected in three patients, leading to abolition of paroxysmal supraventricular tachycardia in two.
- One patient experienced coronary sinus perforation, necessitating pericardial aspiration.
- The procedure demonstrated limited efficacy and was associated with significant risks and time commitment.
Conclusions:
- Direct current electrical ablation at the coronary sinus ostium is a complicated procedure with limited efficacy for posteroseptal accessory pathways.
- Coronary sinus perforation is a significant risk associated with this method.
- Surgical intervention remains the preferred curative treatment for arrhythmias caused by posteroseptal accessory pathways.