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Initial Low Temperature Setting in Radiofrequency Catheter Ablation of Wolff‐Parkinson‐White Syndrome
Author(s) -
VEGAARRILLAGA FRANCES,
YOUNG MINGLON,
WU JINGMING,
WOLFF GRACE S.
Publication year - 2000
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.1540-8159.2000.tb00782.x
Subject(s) - medicine , accessory pathway , ablation , catheter ablation , block (permutation group theory) , radiofrequency catheter ablation , cardiology , anesthesia , surgery , geometry , mathematics
Previous studies have shown that with low temperature testing for RF ablation of arrhythmias, unnecessary irreversible myocardial lesions may be avoided. In children admitted/or RF ablation from June 1996 to May 1999, we evaluated the method of an initial temperature setting of 50°C for a maximum of 10 seconds. If accessory pathway block occurred, the temperature setting was immediately increased to 70°C and continued for 45–120 seconds (group 1). If accessory pathway block did not occur after several attempts, subsequent attempts were made with initial settings at 70°C–80°C at the same or different sites (group 2). Eighty patients with Wolff‐Parkinson‐White syndrome (mean age 11 ± 4 years) were treated using this method. Twelve patients were excluded for various reasons. Of the remaining 68 patients, 52 (76%) had successful block of the pathway at 50°C; 16 patients demonstrated block only at the higher temperature setting of 70°C–80°C. There were no statistically significant differences between these two groups in terms of age, weight, and location of accessory pathways. Unsuccessful 50°C test ablation attempts were 1.6 ± 2.4 in group 1 and 3.1 ± 2.9 in group 2 (P = 0.04). Total unsuccessful attempts were 1.6 ± 2.4 in group 1 and 8.1 ± 7.1 in group 2 (P = 0.001). The time from application of RF energy to the time of AP block in group 1 was not significantly different from group 2. In the majority of children, successful RF ablation can be achieved by using a temperature setting of 50°C, then 70°C. This will prevent unnecessary permanent injury at unsuccessful attempt sites.