[Radiofrequency catheter ablation: theoretical and technical aspects].
Radiofrequency currents produce circumscribed tissue necrosis by progressive and localised heating. Endocardial application via the percutaneous approach with a specific electrophysiological catheter enables destruction of the anatomical substrate of many cardiac arrhythmias. The technique is well tolerated due to the absence of barometric phenomena and general anaesthesia, and the possibility of modulating the energy delivered, which explains why it has supplanted fulguration in most indications. The technological evolution aims to increase the lesional power and decrease the number of complications. This implies the development of catheters capable of delivering greater currents without the risk of thrombus formation and of generators dependent on electrical or thermal parameters. The low incidence of complications reported by centres using the technique is based on an excellent understanding of the technique, the use of appropriate material, the surveillance of parameters which allow detection of unwanted effects and the respect of a strict operation protocol. In the absence of these precautions, the wide diffusion of this technique, favored by its low cost and relative simplicity, may be associated with an increase in the number of side effects which could be lethal. This cannot be accepted in a technique with such wide indications, including arrhythmias with a usually benign long-term prognosis.
Lavergne
T
T
Département de cardiologie, service A, hôpital Broussais, Paris.
Sebag
C
C
Ollitrault
J
J
Iliou
M C
MC
Le Heuzey
J Y
JY
Guize
L
L
D000818:Animals; D055592:Biophysical Phenomena; D001703:Biophysics; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D006801:Humans
Ablation par courants de radiofréquence; aspects théoriques et techniques.