[Immediate complications of fulguration of ventricular tachycardia and accessory pathways. Analysis of 318 endocavitary shocks].
Abnormal events occurring immediately following electric stimulation were studied in 85 patients--mean age 38.5 years (14-78)--during the performance of 318 intracardiac shocks applied in 110 sessions. This electric stimulation was done for treatment of tachycardias related to an accessory pathway (series AP: 64 patients), or ventricular tachycardias (series VT: 21 patients). The number of shocks per session was 2.4 +/- 1.4 and 4.6 +/- 3, for the series AP and VT respectively, and the cumulative energy per session, was 405 +/- 221 J and 1,007 +/- 735 J. Only events occurring within the first 30 minutes following the shocks, were evaluated. In the series AP, the 64 patients received a total of 208 shocks in 86 sessions, and 68 abnormal events were observed (33%): 35 complete atrio-ventricular blocks, of more than 10 seconds (17%), 29 sinus pauses exceeding 3 seconds (14%) and able to stretch to 30 seconds, 3 ventricular fibrillations (1.4%) and 1 atrial fibrillation. In the series TV, 21 patients received 110 shocks in 24 sessions, and only 10 abnormal events occurred (9%): 2 transient episodes of electromechanical dissociation (1.8%), 3 uniform VT (2.7%), 1 complete atrio-ventricular block (10 min.), 1 cardiac pause (4 sec), 1 ventricular fibrillation, 1 isolated haemodynamic depression and 1 Prinzmetal syndrome. All these events were temporary, 5 ventricular arrhythmias in 6 were treated with a new intracardiac shock, and there were no deaths related to electric stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)
Montserrat
P
P
Service de Cardiologie, Hôpital Saint-André, Bordeaux.
Haissaguerre
M
M
Le Métayer
P
P
Warin
J F
JF
Blanchot
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D004599:Electric Stimulation Therapy / Q000009:adverse effects*; D005260:Female; D006327:Heart Block / Q000209:etiology; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D013610:Tachycardia / Q000628:therapy*; D013997:Time Factors; D014927:Wolff-Parkinson-White Syndrome / Q000628:therapy*
D007527:Isoenzymes; D003402:Creatine Kinase
Complications immédiates de la fulguration des tachycardies ventriculaires et des voies accessoires. Analyse de 318 chocs endocavitaires.