フルテキストファイル
著者
Suga Toshimitsu First Department of Internal Medicine, Faculty of Medicine, Tottori University
Igawa Osamu First Department of Internal Medicine, Faculty of Medicine, Tottori University
Hisatome Ichiro First Department of Internal Medicine, Faculty of Medicine, Tottori University 研究者総覧 KAKEN
キーワード
catheter dislodgment
sequential pacing
radiofrequency catheter ablation
Wolff-Parkinson-White syndrome
抄録
We hypothesized that the atrio-ventricular (AV) dissociation occurring after elimination of the accessory pathway conduction during right ventricular (RV) pacing made the stability of the ablation catheter worse. We confirmed this hypothesis by using a pacing model. As a simulation model, sequential ventriculo-atrial (VA) pacing was designed and stud ied in 20 pa tients without VA conduction. Prior to the sequential VA pacing, 3 catheters were positioned in the RV, right atrium (RA) and at the tricuspid valve annulus (TVA), respectively. The sequential VA pacing consisted of continuous RV pacing at a cycle length of 600 ms and RA pacing. The RA was paced at an interval of 125 ms following the RV pacing. To induce AV dissociation, RA pacing was abruptly terminated during continuous sequential VA pacing. We observed the motion of the catheter tip on the TVA before and after RA pacing using fluoroscopy in the 30? right anterior oblique (RAO) and 45? left anterior oblique (LAO) views. The catheter tip position in the end-systolic and end-diastolic phases was confirmed in each projection, and the distance of the catheter tip between these 2 phases was measured. The mean value of the catheter tip distance between the 2 phases obtained with sequential VA pacing and fusion beats was 7.5 ± 3.2 and 21.0 ± 8.3 mm in the RAO (P < 0.001) and 8.0 ± 4.5 and 19.0 ± 8.6 mm in the LAO views (P < 0.001), respectively. Further, we proposed a new pacing maneuver to stabilize the ablation catheter position after the elimination of accessory pathway conduction. Using sequential VA pacing, we examined catheter tip movement during RF current delivery in 6 patients with the concealed Wolff-Parkinson-White syndrome. During RF current delivery, catheter dislodgment did not occur in any patients after the accessory pathway was eliminated when no fusion beats occurred. In conclusion, AV dissociation occurring after elimination of the accessory pathway conduction during RV pacing worsened the stability of the ablation catheter. Furthermore, a new pacing maneuver during the RF application provided a useful method for maintaining stable catheter position for catheter ablation of accessory pathways.
出版者
Tottori University Faculty of Medicine
資料タイプ
学術雑誌論文
ISSN・ISBN
1346-8049
書誌ID
AA00892882
掲載誌名
Yonago Acta medica
最新掲載誌名
Yonago Acta medica
43
3
開始ページ
109
終了ページ
120
発行日
2000-11
著者版フラグ
出版社版
著作権表記
Yonago Acta medica 編集委員会
掲載情報
Yonago Acta medica. 2000, 43(3), 109-120
部局名
医学部・医学系研究科・医学部附属病院
言語
英語