title: Laser catheter coagulation of atrial myocardium for ablation of atrioventricular nodal reentrant tachycardia. First clinical experience.
abstract: A new technique for ablation of atrioventricular nodal reentrant tachycardia, using catheter-directed continuous wave Nd-YAG laser light, 1064 nm, via a novel pin-electrode laser catheter, was applied in 10 patients aged 15-63 years (mean 43 years). A total of 22 laser pulses, 1-5 per patient, at 20 or 30 W, of 10-45 s (mean 27 s) were aimed at the postero-inferior aspect of the tricuspid annulus. In all patients the tachycardia was rendered non-inducible at baseline as well as during orciprenaline administration. The amplitudes of the local atrial potentials diminished from 2.0 +/- 0.5 before to 0.4 +/- 0.4 mV after ablation, atrio-His intervals increased from 73 +/- 7 to 157 +/- 36 ms. Anterograde atrioventricular nodal refractory periods (212 +/- 31 vs 238 +/- 31 ms) and Wenckebach rate (174 +/- 8 vs 167 +/- 8 beats.min-1) did not change significantly (P > 0.05). There were no complications or recurrent arrhythmias in a follow-up of 12-35 (mean 27) months. Anatomically guided laser catheter coagulation of the postero-inferior aspect of the tricuspid valve ring is a safe and effective method for the cure of patients with common atrioventricular reentrant tachycardia.
authors.affiliation: I. Medical Department, Hospital Harlaching, Teaching Hospital, University of Munich, Germany.
authors.forename: H P
authors.initials: HP
authors.lastname: Weber
authors.forename: W
authors.initials: W
authors.lastname: Kaltenbrunner
authors.forename: A
authors.initials: A
authors.lastname: Heinze
authors.forename: K
authors.initials: K
authors.lastname: Steinbach
mesh_terms: D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery*; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D009921:Metaproterenol; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009921:Metaproterenol