[Catheter ablation in sinus node tachycardia].
Sinus node tachycardia is an uncommon cause of paroxysmal supraventricular tachycardia. Of those patients who were referred to our clinic for electrophysiologic evaluation and catheter ablation, four patients (1 male, 3 female) were found to have sinus node tachycardia. The diagnosis of sinus node tachycardia required all of the following: The P-wave during sinus rhythm had to be similar to the P-wave during the tachycardia, the atrial activation sequence during sinus rhythm and tachycardia had to be similar, the origin of the tachycardia had to be in the high right atrium. In one patient the tachycardia was incessant. The other three patients had paroxysmal sinus node tachycardia that could be induced by programmed atrial stimulation. No patient had overt cardiac disease. One patient had an inducible av nodal reentrant tachycardia and one patient had a second atrial tachycardia originating from the basal right atrium. Activation mapping during tachycardia was performed in all patients. Local atrial activation at the site of successful ablation preceded the P-wave in the surface electrocardiogram by 54 +/- 43 ms. In three patients the interval from the local atrial activation at the site of successful catheter ablation to the onset of the signal from the high right atrium (HRA) ranged from 25 ms to 125 ms, in one patient the signal from the high right atrium was the earliest recorded signal during tachycardia. In all patients the tachycardia was terminated with the application of radiofrequency current. Two to a maximum of 12 radiofrequency current applications were necessary; complications were not observed. In all patients a second electrophysiologic study was performed 8 +/- 2 weeks after successful catheter ablation; no patient had inducible sinus node or atrial tachycardia. During a follow-up of 5 +/- 2 months, no patient had a recurrence of sinus node tachycardia or required antiarrhythmic medication. It is concluded that catheter ablation in patients with sinus node tachycardia is an effective and safe treatment.
Kühlkamp
V
V
Medizinische Klinik Abteilung III, Tübingen.
Mermi
J
J
Böhringer
K
K
Mewis
C
C
Seipel
L
L
D000328:Adult; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012849:Sinoatrial Node / Q000503:physiopathology / Q000601:surgery; D013616:Tachycardia, Sinus / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
Katheterablation bei Sinusknotentachykardie.