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European Heart Journal 1984 5(2):126-129;
Copyright © 1984 by the European Society of Cardiology.
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© 1984 The European Society of Cardiology

Emergency transvenous ablation of atrioventricular conduction to control refractory atrial tachycardia

D.E. WARD, S. JONES and R.V. GIBSON

Cardiology Department, Brompton Hospital London, U.K.

Received 20 July 1983; revised 16 September 1983; .

Address for correspondence: D. E. Ward, MD, Cardiology Department, St George's Hospital, London SW17 OQT.

Abstract

Three patients were referred for urgent investigation and treatment of refractory arrhythmias. Each patient had failed to respond to antiarrhythmic drugs and in two patients direct current cardioversion was also unsuccessful. Transvenous ablation of atrioventricular conduction was therefore thought appropriate. With a temporary ventricular pacing system in situ, a second electrode was used to record His and atrial electro-grams. A 270 watt-second shock was delivered through this lead when the His potential was maximized. The tachycardia was controlled in two patients and the procedure was without deleterious effects.

Key Words: Refractory arrhythmias • transvenous His bundle ablation


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