Catheter-induced ablation of the atrioventricular junction using DC shocks produced complete AV block in 100% (5/5) of patients with refractory supraventricular tachycardia.
Case Report (n=5)
Does catheter-induced ablation of the AV junction using DC shocks produce complete AV block in patients with refractory supraventricular tachycardia?
Catheter-induced DC shock ablation of the His bundle successfully produced complete AV block in patients with refractory supraventricular tachycardia, demonstrating early feasibility of a percutaneous alternative to open-heart surgical ablation.
Five patients with recurrent bouts of supraventricular tachycardia proved resistant or became intolerant of both conventional and experimental drugs. These patients were subjected to a new procedure involving delivery of DC shocks to an electrode catheter positioned adjacent to the His bundle. Complete atrioventricular (AV) block was produced in all, one patient died suddenly six weeks after shock therapy, and the remainder had complete AV block with follow-up intervals ranging from four to 12 months. Shock therapy was associated with mild elevations of creatine phosphokinase MB (31± 18 units), but there was no hemodynamic evidence of tricuspid insufficiency. If this new technique proves safe and effective, it should supplant the need for open heart surgical procedures for His-bundle ablation. (JAMA1982;248:851-855)
Melvin M. Scheinman (1982) conducted a case report in Refractory supraventricular tachycardia (n=5). Catheter-induced ablation of the atrioventricular junction (DC shocks) was evaluated on Complete atrioventricular (AV) block. Catheter-induced ablation of the atrioventricular junction using DC shocks produced complete AV block in 100% (5/5) of patients with refractory supraventricular tachycardia.