[Long-term course after electric ablation of the bundle of His in the treatment of supraventricular tachycardia].
The authors report the long term results of His bundle ablation for supraventricular tachycardia in a series of 49 patients. This retrospective study was based on a patient population of 27 men and 22 women with an average age of 59 at the time of ablation, between 1984 and 1993. The indication for His bundle ablation was invalidating supraventricular tachycardia resistant to antiarrhythmic therapy in all cases. One group of patients (Group I, n = 31 patients) underwent high energy electrical shock and the second group (Group II, n = 18 patients) recruited after 1991, underwent radiofrequency catheter ablation. Complete atrioventricular block was obtained in the first group in 1 to 4 sessions whereas 17 patients of Group II were treated in a single session. During a follow-up period of an average of 40 months, 2 patients were lost to follow-up and 6 died, 3 of cardiac failure, 1 of a cerebrovascular accident, 1 of pulmonary carcinoma and 1 of unknown cause. In Group I, atrioventricular conduction persisted in 1 patient (primary failure) and reappeared in one other patient, but, in Group II, complete atrioventricular block persisted even in the patient in whom the interruption was not obtained with a single session of radiofrequency ablation. The patients were generally physically improved and satisfied not to have any palpitations. A decrease in exercise capacity estimated by the NYHA classification was observed in 38% of patients without apparent cardiac disease who developed dyspnea. On the other hand, 43% of patients with cardiac disease and in NYHA class > or = 2 were improved.(ABSTRACT TRUNCATED AT 250 WORDS)
Canu
G
G
Service de cardiologie, hôpital cardiovasculaire et pneumologique Louis-Pradel, Lyon.
Moncada
E
E
Claudel
J P
JP
Bellon
C
C
Buttard
P
P
Sommier
J M
JM
Kirkorian
G
G
Touboul
P
P
D000328:Adult; D000368:Aged; D002036:Bundle of His; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013617:Tachycardia, Supraventricular / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors
Evolution à long terme après ablation électrique du faisceau de His dans le traitement des tachycardies supraventriculaires.