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Low Energies and Helifix Electrodes in the Successful Ablation of Atrioventricular Conduction
Author(s) -
HOLT P. M.,
BOYD E. G. C. A.,
CRICK J. C. P.,
SOWTON E.
Publication year - 1985
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1985.tb05875.x
Subject(s) - medicine , ablation , cardiology , atrioventricular node , electrode , electrical conduction system of the heart , catheter ablation , electrocardiography , tachycardia , chemistry
High energies delivered via standard pacing catheter electrodes produce permanent atrioventricular conduction block and generate high pressures. We investigated the use of lower energies and an active fixation electrode. Ten patients with refractory supraventricular tachycardias (six with paroxysmal atrial fibrillation, three with dual AV nodal pathways, and one with a concealed accessory atrioventricular pathway) were treated. A 6F Vitatron Helifix electrode was positioned to give the maximum His bundle deflection. Four shocks of only 50 joules each were delivered at 1‐minute intervals. Long‐term follow‐up showed that seven patients (70%) had persistent complete heart block and two had atrial fibrillation with slower ventricular rates. Nine patients (90%) were symptom‐free without antiarrhythmic therapy. Permanent pacemakers were implanted in eight patients. There were no complications resulting from the procedure. Transvenous ablation of atrioventricular conduction can be safely achieved using a Vitatron Helifix eleclrode and much lower energy values than have been previously employed.