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European Heart Journal 1997 18(3):487-495;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Laser catheter coagulation of atrial myocardium for ablation of atrioventricular nodal reentrant tachycardia

First clinical experience

H. P. Weber*,, W. Kaltenbrunner{dagger}, A. Heinze* and K. Steinbach{dagger}

*Laser and Clinical Cardiac Electrophysiology Laboratory, 1. Medical Department, Hospital Harlaching, Teaching Hospital, University of Munich Munich, Germany
{dagger}Ludwig-Boltzmann-Institut für Arrhythmieforschung Vienna, Austria

Received 24 April 1996; accepted 2 May 1996.

Correspondence: Dr Helmut P. Weber, Kramerstra§e 13, D-81062 Neuried, Germany

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.

Key Words: laser • catheter ablation • atrioventricular nodal reentrant tachycardia • supraventricular tachycardia


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