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Radiofrequency catheter ablation of supraventricular tachycardia in patient with deep brain stimulator.

ABSTRACT: Safety of radiofrequency ablation in patients with deep brain stimulation systems is not known. We report a patient with a deep brain stimulator who has undergone radiofrequency ablation.

SUBMITTER: Baskovski E

PROVIDER: S-EPMC10014625 | biostudies-literature | 2023 Mar-Apr

REPOSITORIES: biostudies-literature

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Radiofrequency catheter ablation of supraventricular tachycardia in patient with deep brain stimulator.

Baskovski Emir E Atan Seyhmus S Ersoy İbrahim İ

Indian pacing and electrophysiology journal 20230206 2

Safety of radiofrequency ablation in patients with deep brain stimulation systems is not known. We report a patient with a deep brain stimulator who has undergone radiofrequency ablation. ...[more]

PMID: 36754208

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Right coronary artery compromise following radiofrequency catheter ablation for supraventricular tachycardia: cases reports.

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Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Patients With Pulmonary Hypertension: Feasibility and Long-Term Outcome.

Project description:BackgroundSupraventricular tachycardia (SVT) occurs commonly and is strongly correlated with clinical deterioration in patients with pulmonary hypertension (PH). This study aimed to investigate the feasibility and long-term outcome of radiofrequency catheter ablation (RFCA) in PH patients with SVT.Materials and methodsConsecutive PH patients with SVT who were scheduled to undergo electrophysiological study and RFCA between September 2010 and July 2019 were included. The acute results and long-term success of RFCA were assessed after the procedure.ResultsIn total, 71 PH patients with 76 episodes of SVT were analyzed. Cavotricuspid isthmus-dependent atrial flutter (n = 33, 43.5%) was the most common SVT type, followed by atrioventricular nodal reentrant tachycardia (n = 16, 21.1%). Of the 71 patients, 60 (84.5%) underwent successful electrophysiological study and were subsequently treated by RFCA. Among them, acute sinus rhythm was restored in 54 (90.0%) patients, and procedure-related complications were observed in 4 (6.7%) patients. Univariate logistic regression analysis showed that cavotricuspid isthmus-independent atrial flutter [odds ratio (OR) 25.00, 95% confidence interval (CI) 3.45-180.98, p = 0.001] and wider pulmonary artery diameter (OR 1.19, 95% CI 1.03-1.38; p = 0.016) were associated with RFCA failure. During a median follow-up of 36 (range, 3-108) months, 7 patients with atrial flutter experienced recurrence, yielding a 78.3% 3-year success rate for RFCA treatment.ConclusionThe findings suggest that RFCA of SVT in PH patients is feasible and has a good long-term success rate. Cavotricuspid isthmus-independent atrial flutter and a wider PAD could increase the risk for ablation failure.

| S-EPMC8249814 | biostudies-literature

Outcomes of deep sedation for catheter ablation of paroxysmal supraventricular tachycardia, with adaptive servo ventilation.

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Project description:A case report involving incessant multi-types of supraventricular tachycardia and acute decompensated heart failure required a rescuing electrophysiology study and ablation. Ventricular fibrillation occurred due to coronary spasm, complicating the deteriorating heart. However, aggressive therapies, including extracorporeal support and the timely elimination of the culprit accessory pathway, successfully resolved the patient's condition.

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Long term prognosis in patients with pulmonary hypertension undergoing catheter ablation for supraventricular tachycardia.

Project description:Various forms of supraventricular tachycardia (SVT) occur in patients with severe pulmonary hypertension (PH). Despite the high efficacy of radiofrequency catheter ablation (RFCA) for SVT, insufficient data exist regarding patients with PH. Thirty SVTs in 23 PH patients (age 47 [35-60] years; mean pulmonary artery pressure 44 [32-50] mmHg) were analyzed. Procedural success rate, short- and long-term clinical outcomes, were evaluated during a median follow-up of 5.1 years. Single-procedure success rate was 83%; 94% (17/18) in typical atrial flutter, 73% (8/11) in atrial tachycardia (AT), and 100% (1/1) in atrioventricular nodal reentrant tachycardia. Antiarrhythmic drugs, serum brain natriuretic peptide levels and number of hospitalizations significantly decreased after RFCA than that before (p = 0.002, 0.04, and 0.002, respectively). Four patients had several procedures. After last RFCA, 12 patients had SVT and 8 patients died. Kaplan-Meier curves showed that patients with SVT after the last RFCA had a lower survival rate compared to those without (p = 0.0297). Multivariate analysis identified any SVT after the last RFCA as significant risk factor of mortality (hazard ratio: 9.31; p = 0.016). RFCA for SVT in patients with PH is feasible and effective in the short-term, but SVT is common during long-term follow-up and associated with lower survival.

| S-EPMC8355112 | biostudies-literature

Anterior mitral leaflet perforation: a rare complication of radiofrequency ablation for paroxysmal supraventricular tachycardia.

Project description:A 9-year-old girl with a ten-day history of palpitations was referred for the assessment of mitral regurgitation. She had had RF ablation for paroxysmal supraventricular tachycardia 5 years previously. Echocardiography showed isolated anterior mitral leaflet perforation. Surgical findings confirmed the echocardiographic assessment.

| S-EPMC5538059 | biostudies-other

Radiofrequency catheter ablation for inappropriate sinus tachycardia in a patient with systemic lupus erythematosus: a case report.

Project description:Systemic lupus erythematosus (SLE) is known to cause inappropriate sinus tachycardia (IST). However, there is limited evidence available with regard to the treatment of IST in this setting. In this article, we report a case of drug refractory IST in a patient with SLE treated with radiofrequency catheter ablation (RFCA) using a non-contact mapping system. A 33-year-old woman had been diagnosed with SLE in 2001. She presented with complaints of persistent palpitations for 1 month and persistent sinus tachycardia. She underwent RFCA using a non-contact mapping system for drug refractory IST. The voltage and activation maps did not show obvious differences in the earliest activation site at heart rates (HRs) 90-150 b.p.m. In contrast, the areas of breakout sites were clearly distinguished between those from the normal P-wave zones at HR <140 b.p.m. and those from higher rate sites at HR >140 b.p.m. Radiofrequency catheter ablation was performed in those areas as the target for ablation. Thereafter, the symptoms steadily disappeared and the maximum HR-using 24-h Holter monitoring-decreased from 156 to 120 b.p.m. Radiofrequency catheter ablation using a non-contact mapping system was applied to the treatment of drug refractory IST in a patient with SLE. Of note, IST in such patients may be left untreated. This approach may be considered as a first-line therapy option for drug refractory IST in patients with SLE.

| S-EPMC6764560 | biostudies-literature

Cost-Effectiveness of Radiofrequency Ablation for Supraventricular Tachycardia in Guatemala: Patient outcomes and economic analysis from a low-middle-income country.

Project description:BackgroundRadiofrequency ablation (RFA) is an established but expensive treatment alternative for many forms supraventricular tachycardia (SVT). Currently no studies exist on the cost-effectiveness of RFA compared to medical treatment (MT) in adult Latin American population.MethodsBetween 2007 and 2012, we identified 103 adults who underwent RFA for SVT in the National Unit of Cardiovascular Surgery (UNICAR) in Guatemala. A decision tree was developed with all clinical outcome parameter estimates obtained from the Adult Electrophysiology Clinic. Costs were obtained from UNICAR's administration. A cost-effectiveness analysis was conducted which evaluated costs and quality adjusted life years (QALYs) to compare interventions in terms of their incremental cost-effectiveness ratios (ICERs).ResultsThe first RFA had 83% success and cumulative 94% success was achieved with a second one. The cost of the RFA procedure itself was $5,411. RFA gains 1.46 QALYs and saves $ 7,993 compared to of MT for patients with SVT. This demonstrates that in Guatemala, RFA dominates MT in the management of SVT. Using assumptions based largely on the outcomes in UNICAR, we found that the RFA is highly cost-effective. This is a consistent finding, even after varying assumptions about efficacy, complication rates and quality of life.ConclusionsRFA dominates MT by improving quality of life and reducing expenditures when used to treat severely symptomatic patients with SVT in Guatemala. The robustness of these finding to variations in parameter assumptions, suggests these findings may hold in other similar settings.

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Left ventricle penetration-A rare complication of transseptal puncture and catheter ablation for supraventricular tachycardia.

Project description: Not available

| S-EPMC5419514 | biostudies-literature

Catheter ablation of supraventricular tachycardia in patients with and without structural heart disease: insights from the German ablation registry.

Project description:AimTo compare patient characteristics, safety and efficacy of catheter ablation of supraventricular tachycardia (SVT) in patients with and without structural heart disease (SHD) enrolled in the German ablation registry.Methods and resultsFrom January 2007 until January 2010, a total of 12,536 patients (37.2% with known SHD) were enrolled and followed for at least one year. Patients with SHD more often underwent ablation for atrial flutter (45.8% vs. 20.9%, p < 0.001), whereas patients without SHD more often underwent ablation for atrioventricular nodal reentrant tachycardia (30.2% vs. 11.8%, p < 0.001) or atrioventricular reentrant tachycardia (9.1% vs. 1.6%, p < 0.001). Atrial fibrillation catheter ablation procedures were performed in a similar proportion of patients with and without SHD (38.1% vs. 36.9%, p = 0.21). Overall, periprocedural success rate was high in both groups. Death, myocardial infarction or stroke occurred in 0.2% and 0.1% of patients with and without SHD (p = 0.066). Major non-fatal complications prior to discharge were rare and did not differ significantly between patients with and without SHD (0.5% vs. 0.4%, p = 0.34). Kaplan-Meier mortality estimate at 1 year demonstrated a significant mortality increase in patients with SHD (2.6% versus 0.7%; p < 0.001).ConclusionPatients with and without SHD undergoing SVT ablation exhibit similar success rates and low major complication rates, despite disadvantageous baseline characteristics in SHD patients. These data highlight the safety and efficacy of SVT ablation in patients with and without SHD. Nevertheless Kaplan-Meier mortality estimates at 1 year demonstrate a significant mortality increase in patients with SHD, highlighting the importance of treating the underlying condition and reliable anticoagulation if indicated.

| S-EPMC9054935 | biostudies-literature

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