Saroja Bharati.
Maurice Lev Congenital Heart and Conduction System Center, The Heart Institute for Children, Hope Children’s Hospital, Christ Hospital and Medical Center, Oak Lawn, Rush Medical College, Rush University, Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Finch University of Health Sciences, Chicago Medical School, North Chicago, University of Illinois at Chicago, Chicago, USA
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Today radiofrequency ablation is the method of
choice to treat all types of cardiac arrhythmias in all age groups. This is being done without
significant damage to the atrio-ventricular node and the atrioventricular bundle, thereby
preventing the need for implantation of a permanent pacemaker1-15. However, procedure
related complete atrioventricular block either transient or permanent may occur rarely16-20.
Likewise, recurrence of arrhythmias have been reported21. In general, the quality of life
has been demonstrated to improve significantly following radiofrequency ablation for all
types of supraventricular arrhythmias14,22-24. However, radiofrequency ablation of
intractable drug resistant arrhythmias, such as atrial flutter and fibrillation remain a
challenge for the electrophysiologist14. The problems following radiofrequency ablation for
atrial flutter and/or fibrillation are: Pacemaker dependency following atrioventricular node
ablation, ventricular tachycardia and sudden death. Although atrial fibrillation and atrial
flutter may originate from multiple sites of both atria, selective radiofrequency ablation of
arrhythmias originating from focal areas has been attempted rarely.
The pathological findings in atrial fibrillation ablation in the chronic dog model by
radiofrequency energy is compared with the pathological findings following circumferential
ablation of pulmonary vein ostia with a new ultrasound ablation catheter to see if the
latter technique can be applied in the human25-31.
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