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BACKGROUND Atrioventricular nodal reentrant tachycardia (AVNRT), the most common form of supraventricular tachycardia, results from conduction through a reentrant circuit comprising fast and slow atrioventricular nodal pathways. Antiarrhythmic-drug therapy is not consistently successful in controlling this rhythm disturbance. Catheter ablation of the fast(More)
BACKGROUND Surgical or catheter ablation of accessory pathways by means of high-energy shocks serves as definitive therapy for patients with Wolff-Parkinson-White syndrome but has substantial associated morbidity and mortality. Radiofrequency current, an alternative energy source for ablation, produces smaller lesions without adverse effects remote from the(More)
The utility of procainamide, up to 10 mg/kg IV, as a provocative test for intermittent high degree atrioventricular (AV) block was evaluated in a total of 89 patients. Forty two patients had resting 1:1 AV conduction but had bifascicular block and a history of syncope. High degree AV block had not been documented in anyone. Before procainamide, the HV(More)
Patients with atrial fibrillation or atrial flutter (AF) are candidates for radiofrequency (RF) catheter ablation of the atrioventricular (AV) node with the aim being to control heart rate. As patients with AF can have markedly impaired ventricular function, information concerning the hemodynamic effects of AV node ablation using RF current would be(More)
BACKGROUND Although radiofrequency catheter ablation of the atrioventricular (AV) node is an established treatment for atrial fibrillation (AF) with uncontrolled ventricular response, factors that predict clinical outcome in patients with associated congestive heart failure (CHF) are unknown. METHODS AND RESULTS AV node ablation and permanent pacemaker(More)
Catheter ablation of 215 accessory pathways (APs) using radiofrequency current (RF) was attempted in 204 consecutive patients. Two hundred twelve of the 215 (99%) APs were successfully ablated. After a minimum of follow-up period of 1 month (mean 8.5 +/- 5.4 months), AP conduction had returned in 17 patients (8%). Recurrence of AP conduction was manifest by(More)
The effects of intravenous boluses of amiodarone (5 mg/kg), racemic sotalol (enantiomeric ratio d/l-sotalol 1:1;1.5 mg/kg), and d-sotalol (0.75 mg/kg) on mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), total peripheral resistance (TPR), left ventricular end-diastolic pressure (LVEDP), and peak rate of change of left ventricular pressure(More)
Radiofrequency (RF) catheter ablation of the atrioventricular node (AVN) and implantation of a ventricular pacemaker can improve cardiac performance in patients with congestive heart failure (CHF) and uncontrolled atrial fibrillation (AF). Alternatively, RF catheter modification of the AVN has been proposed to slow ventricular response during AF without(More)
The periodicity of symptoms in patients who present with syncope restricts the diagnostic value of prolonged electrocardiographic monitoring and furthermore, demonstration of arrhythmias in the absence of symptoms may not enable a firm diagnosis. Because of this, electrophysiology study is often necessary. A series of 89 consecutive patients with syncope of(More)
Electrophysiology study was performed in 93 patients with bifascicular block and unexplained syncope. Clinical evidence of organic heart disease was present in 33 (35%). Electrophysiological abnormalities were detected in 45 patients (48%). Of these, 36 had distal conduction disease, including 28 with an HV interval greater than 55 ms (mean 76.4 ms), and(More)