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January 5, 1990, Vol 263, No. 1 >
ARTICLE | January 5, 1990

Catheter and Surgical Treatment of Cardiac Arrhythmias FREE

Melvin Scheinman, MD
[+] Author Affiliations

This article is one of a series sponsored by the American Heart Association.

Reprint requests to Room 312, Moffitt Hospital, 505 Parnassus Ave, University of California, San Francisco, CA 94143 (Dr Scheinman).


JAMA. 1990;263(1):79-82. doi:10.1001/jama.1990.03440010077035
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Article
References

Over the past decade, numerous impressive advances have been made using nonpharmacologic methods for control of cardiac arrhythmias. These methods include surgical or catheter ablation of abnormal foci. Current techniques involve catheter ablation of the atrioventricular junction to control supraventricular arrhythmias. In addition, surgical techniques have proved to be remarkably safe and effective for treatment of patients with accessory pathways and those with atrioventricular nodal reentrant tachycardia. Patients with drug-refractory ventricular tachycardia may benefit from surgical resection of the ventricular tachycardia focus. The use of these interventional methodologies has radically altered the approach to management of patients with drug-refractory cardiac arrhythmias.

(JAMA. 1990;263:79-82)

REFERENCES

1 +
Scheinman MM.  Nonpharmacologic treatment of life-threatening cardiac arrhythmias . Am Heart J. 1987;;114:1291-1298.
2 +
Gonzalez R, Scheinman M, Thomas A, Desai J, Peters R, Dzindzio B.  Electrophysiologic characterization of surgically induced His bundle rhythm in man . PACE. 1981;;4:152-162.
3 +
Klein GJ, Sealy WC, Pritchett EL, et al.  Cryosurgical ablation of the atrioventricular node—His bundle: long-term follow-up and properties of the junctional pacemaker . Circulation. 1980;;61:8-15.
4 +
Scheinman MM, Morady F, Hess DS, Gonzalez R.  Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmia . JAMA. 1982;;248:851-855.
5 +
Gallagher JJ, Svenson RH, Kasell JH, et al.  Catheter technique for closed-chest ablation of the atrioventricular conduction system: a therapeutic alternative for the treatment of refractory supraventricular tachycardia . N Engl J Med. 1982;;306: 194-200.
6 +
Evans GT Jr, Scheinman MM, Zipes DP, et al.  The Percutaneous Cardiac Mapping and Ablation Registry: final summary of results . PACE. 1988;; 11:1621-1626.
7 +
Rosen KM, Mehta A, Miller RA.  Demonstration of dual atrioventricular nodal pathways in man . Am J Cardiol. 1974;;33:291.
8 +
Scheinman MM.  Atrioventricular nodal or atriojunctional reentrant tachycardia . J Am Coll Cardiol. 1985;;76:1329-1336.
9 +
Cox JL, Holman WL, Cain ME.  Cryosurgical treatment of atrioventricular node reentrant tachycardia . Circulation. 1987;;76:1329-1336.
10 +
Ross DL, Johnson DC, Denniss AR, Cooper MJ, Richards DA, Uther JB.  Curative surgery for atrioventricular junctional (`AV nodal') reeentrant tachycardia . J Am Coll Cardiol. 1985;;6:1383-1392.
11 +
Haissaguerre M, Warin JF, Lemetayer P, Saoudi N, Guillem JP, Blanchot P.  Closed-chest ablation of retrograde conduction in patients with atrioventricular nodal reentrant tachycardia . N Engl J Med. 1989;;320:426-433.
12 +
Epstein LM, Langberg JJ, Herre JM, Griffin JC, Scheinman MM.  Catheter modification of the atrioventricular node: a potential cure for atrioventricular nodal reentrant tachycardia . Circulation . In press.
13 +
Gallagher JJ, Pritchett ELC, Sealy WC, et al.  The preexcitation syndromes . Prog Cardiovasc Dis. 1978;;2:285.
14 +
Cox JL, Gallagher JJ, Cain ME.  Experience with 118 patients undergoing operation for the Wolff-Parkinson-White syndrome . J Thorac Cardiovasc Surg. 1985;;90:490-501.
15 +
Guiraudon GM, Klein GJ, Sharma AD, Milstein S, McLean DG.  Closed heart technique for Wolff-Parkinson-White syndrome: further experience and potential limitations . Ann Thorac Surg. 1986;;42:651-657.
16 +
Fisher JD, Brodman R, Kim SG, et al.  Attempted nonsurgical electrical ablation of accessory pathways via the coronary sinus in the Wolff-Parkinson-White syndrome . J Am Coll Cardiol. 1984;;4:685-694.
17 +
Morady F, Scheinman MM, Kou WH, et al.  Long-term results in patients undergoing catheter ablation of a posteroseptal accessory atrioventricular connection . Circulation . In press.
18 +
Warin JF, Haissaguerre M, Lemetayer P, Guillem JP, Blanchot P.  Catheter ablation of accessory pathways with a direct approach: results in 35 patients . Circulation. 1988;;78:800-815.
19 +
Wyndham CRC, Arnsdorf MF, Levitsky S, et al.  Successful surgical excision of focal paroxysmal atrial tachycardia: observations in vivo and in vitro . Circulation. 1989;;62:1365-1372.
20 +
Cox JL.  The status of surgery for cardiac arrhythmias . Circulation. 1985;;71:413-417.
21 +
Davis J, Scheinman MM, Ruder MA, et al.  Ablation of cardiac tissues by an electrode catheter technique for treatment of ectopic supraventricular tachycardia in adults . Circulation. 1986;;74:1044-1053.
22 +
Gillette PC, Zinner A.  The use of fulguration in the treatment of tachydysrhythmias in children . In: Fontaine G, Scheinman MM, eds. Ablation in Cardiac Arrhythmias . Mount Kisco, NY: Futura Publishing Co Inc; 1987;:269-276.
23 +
Josephson ME, Horowitz LN, Spielman SR, Waxman HL, Greenspan AM.  Role of catheter mapping in the preoperative evaluation of ventricular tachycardia . Am J Cardiol. 1982;;49:207-220.
24 +
Josephson ME, Waxman HL, Cain ME, Gardner MJ, Buxton AE.  Ventricular activation during ventricular endocardial pacing, II: role of pacemapping to localize origin of ventricular tachycardia . Am J Cardiol. 1982;;50:11-22.
25 +
Okumura K, Olshansky B, Henthorn RW, Epstein AE, Plumb VJ, Waldo AL.  Demonstration of the presence of slow conduction during sustained ventricular tachycardia in man: use of transient entrainment of the tachycardia . Circulation. 1987;;75:369-378.
26 +
Morady F, Frank R, Kou WH, et al.  Identification and catheter ablation of a zone of slow conduction in the reentrant circuit of ventricular tachycardia in humans . J Am Coll Cardiol. 1988;;11:775-782.
27 +
Stevenson WG, Weiss J, Wiener I, Wohlgelernter D, Yeatman L.  Localization of slow conduction in a ventricular tachycardia circuit: implications for catheter ablation . Am Heart J. 1987;; 114:1253-1258.
28 +
Miller J, Kienzle M, Harken A, Josephson M.  Subendocardial resection for ventricular tachycardia: predictors of surgical success . Circulation. 1984;;70:624-631.
29 +
Moran JM, Kehoe RF, Loeb JM, Lichtenthal PR, Sanders JH, Michaelis LL.  Extended endocardial resection for the treatment of ventricular tachycardia and ventricular fibrillation . Ann Thorac Surg. 1982;;34:538-552.
30 +
Saksena S.  Laser ablation for tachyarrhythmia control: current status and future developments . In: Brugada D, Wellens HJJ, eds. Cardiac Arrhythmias: Where to Go From Here? Mount Kisco, NY: Futura Publishing Co Inc; 1987;:803-819.
31 +
Guiraudon G, Fontaine G, Frank R, Cabral C, Grosgozeat Y.  Apport de la ventriculomie circulaire d'exclusion: dans le traitement de la tachycardie ventriculaire recidivante apres infartus du myocarde . Arch Mal Coeur. 1982;;75:1013-1020.
32 +
Ostermeyer J, Breithardt G, Borggrefe M, Godehardt E, Seipel L, Bircks W.  Surgical treatment of ventricular tachycardia: complete versus partial encircling endocardial ventriculotomy . J Thorac Cardiovasc Surg. 1984;;87:517-525.
33 +
Josephson ME, Harken AH, Horowitz LN.  Long-term results of endocardial resection for sustained ventricular tachycardia in coronary disease patients . Am Heart J. 1982;;104:51.
34 +
Hartzler GO.  Electrode catheter ablation of refractory focal ventricular tachycardia . J Am Coll Cardiol. 1983;;2:1107.
35 +
Davis JC, Finkebeiner W, Ruder MA, et al.  Histologic changes and arrhythmogenicity after discharge through transseptal catheter electrode . Circulation. 1986;;74:637-644.
36 +
Frank R, Fontaine G, Tonet JL, Grosgogeat Y.  Long-term experience of fulguration for the treatment of ventricular tachycardia . PACE. 1988;; 11:912.
37 +
Morady F, Scheinman MM, DiCarlo LA Jr, et al.  Catheter ablation of ventricular tachycardia with intracardiac shocks: results in 33 patients . Circulation. 1987;;75:1037-1049.
38 +
Haissaguerre M, Warin JF, Lemetayer P, Guillem JP, Blanchot P.  Catheter ablation of ventricular tachycardia using high cumulative energy: results in 28 patients with a mean follow-up of 27 months . PACE. 1988;;11:913.
39 +
Sellers TD, Dilorenzo D, Primerano P, et al.  Catheter ablation of resistant ventricular tachycardia: immediate results and long-term follow-up . PACE. 1988;;11:920.
40 +
Touboul P, Kirkorian G, Atallah G, et al.  Bundle branch reentrant tachycardia treated by electrical ablation of the right bundle branch . J Am Coll Cardiol. 1986;;7:1404-1409.
41 +
Wah Lai JY, Friday K, Olson E, Khan A, Prabhu S, Jackman W.  Selective percutaneous catheter ablation of the right bundle branch in patients with sustained bundle branch reentrant tachycardia . J Am Coll Cardiol. 1986;;7:243. Abstract.
42 +
Borggrefe M, Budde T, Podczeck A, Breithardt G.  High frequency alternating current ablation of an accessory pathway in humans . J Am Coll Cardiol. 1987;;10:576-582.
43 +
Cunningham D, Rowland E, Rickards A.  A new non-arcing electrode for catheter ablation: design and trial performance . Circulation . 1987;; 76(pt II, No. (4) ):IV-405. Abstract.
44 +
Guiraudon GM, Klein GJ, Sharma AD, Yee R.  Use of old and new anatomic, electrophysiologic and technical knowledge to develop operative approaches to tachycardia . In: Brugada D, Wellens HJJ, eds. Cardiac Arrhythmias: Where to Go From Here? Mount Kisco, NY: Futura Publishing Co Inc; 1987;:639-655.
45 +
Klein GJ, Guiraudon GM, Sharma AD, Milstein S.  Demonstration of macroreentry and feasibility of operative therapy in the common form of atrial flutter . Am J Cardiol. 1986;;57:587-591.

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1 +
Scheinman MM.  Nonpharmacologic treatment of life-threatening cardiac arrhythmias . Am Heart J. 1987;;114:1291-1298.
2 +
Gonzalez R, Scheinman M, Thomas A, Desai J, Peters R, Dzindzio B.  Electrophysiologic characterization of surgically induced His bundle rhythm in man . PACE. 1981;;4:152-162.
3 +
Klein GJ, Sealy WC, Pritchett EL, et al.  Cryosurgical ablation of the atrioventricular node—His bundle: long-term follow-up and properties of the junctional pacemaker . Circulation. 1980;;61:8-15.
4 +
Scheinman MM, Morady F, Hess DS, Gonzalez R.  Catheter-induced ablation of the atrioventricular junction to control refractory supraventricular arrhythmia . JAMA. 1982;;248:851-855.
5 +
Gallagher JJ, Svenson RH, Kasell JH, et al.  Catheter technique for closed-chest ablation of the atrioventricular conduction system: a therapeutic alternative for the treatment of refractory supraventricular tachycardia . N Engl J Med. 1982;;306: 194-200.
6 +
Evans GT Jr, Scheinman MM, Zipes DP, et al.  The Percutaneous Cardiac Mapping and Ablation Registry: final summary of results . PACE. 1988;; 11:1621-1626.
7 +
Rosen KM, Mehta A, Miller RA.  Demonstration of dual atrioventricular nodal pathways in man . Am J Cardiol. 1974;;33:291.
8 +
Scheinman MM.  Atrioventricular nodal or atriojunctional reentrant tachycardia . J Am Coll Cardiol. 1985;;76:1329-1336.
9 +
Cox JL, Holman WL, Cain ME.  Cryosurgical treatment of atrioventricular node reentrant tachycardia . Circulation. 1987;;76:1329-1336.
10 +
Ross DL, Johnson DC, Denniss AR, Cooper MJ, Richards DA, Uther JB.  Curative surgery for atrioventricular junctional (`AV nodal') reeentrant tachycardia . J Am Coll Cardiol. 1985;;6:1383-1392.
11 +
Haissaguerre M, Warin JF, Lemetayer P, Saoudi N, Guillem JP, Blanchot P.  Closed-chest ablation of retrograde conduction in patients with atrioventricular nodal reentrant tachycardia . N Engl J Med. 1989;;320:426-433.
12 +
Epstein LM, Langberg JJ, Herre JM, Griffin JC, Scheinman MM.  Catheter modification of the atrioventricular node: a potential cure for atrioventricular nodal reentrant tachycardia . Circulation . In press.
13 +
Gallagher JJ, Pritchett ELC, Sealy WC, et al.  The preexcitation syndromes . Prog Cardiovasc Dis. 1978;;2:285.
14 +
Cox JL, Gallagher JJ, Cain ME.  Experience with 118 patients undergoing operation for the Wolff-Parkinson-White syndrome . J Thorac Cardiovasc Surg. 1985;;90:490-501.
15 +
Guiraudon GM, Klein GJ, Sharma AD, Milstein S, McLean DG.  Closed heart technique for Wolff-Parkinson-White syndrome: further experience and potential limitations . Ann Thorac Surg. 1986;;42:651-657.
16 +
Fisher JD, Brodman R, Kim SG, et al.  Attempted nonsurgical electrical ablation of accessory pathways via the coronary sinus in the Wolff-Parkinson-White syndrome . J Am Coll Cardiol. 1984;;4:685-694.
17 +
Morady F, Scheinman MM, Kou WH, et al.  Long-term results in patients undergoing catheter ablation of a posteroseptal accessory atrioventricular connection . Circulation . In press.
18 +
Warin JF, Haissaguerre M, Lemetayer P, Guillem JP, Blanchot P.  Catheter ablation of accessory pathways with a direct approach: results in 35 patients . Circulation. 1988;;78:800-815.
19 +
Wyndham CRC, Arnsdorf MF, Levitsky S, et al.  Successful surgical excision of focal paroxysmal atrial tachycardia: observations in vivo and in vitro . Circulation. 1989;;62:1365-1372.
20 +
Cox JL.  The status of surgery for cardiac arrhythmias . Circulation. 1985;;71:413-417.
21 +
Davis J, Scheinman MM, Ruder MA, et al.  Ablation of cardiac tissues by an electrode catheter technique for treatment of ectopic supraventricular tachycardia in adults . Circulation. 1986;;74:1044-1053.
22 +
Gillette PC, Zinner A.  The use of fulguration in the treatment of tachydysrhythmias in children . In: Fontaine G, Scheinman MM, eds. Ablation in Cardiac Arrhythmias . Mount Kisco, NY: Futura Publishing Co Inc; 1987;:269-276.
23 +
Josephson ME, Horowitz LN, Spielman SR, Waxman HL, Greenspan AM.  Role of catheter mapping in the preoperative evaluation of ventricular tachycardia . Am J Cardiol. 1982;;49:207-220.
24 +
Josephson ME, Waxman HL, Cain ME, Gardner MJ, Buxton AE.  Ventricular activation during ventricular endocardial pacing, II: role of pacemapping to localize origin of ventricular tachycardia . Am J Cardiol. 1982;;50:11-22.
25 +
Okumura K, Olshansky B, Henthorn RW, Epstein AE, Plumb VJ, Waldo AL.  Demonstration of the presence of slow conduction during sustained ventricular tachycardia in man: use of transient entrainment of the tachycardia . Circulation. 1987;;75:369-378.
26 +
Morady F, Frank R, Kou WH, et al.  Identification and catheter ablation of a zone of slow conduction in the reentrant circuit of ventricular tachycardia in humans . J Am Coll Cardiol. 1988;;11:775-782.
27 +
Stevenson WG, Weiss J, Wiener I, Wohlgelernter D, Yeatman L.  Localization of slow conduction in a ventricular tachycardia circuit: implications for catheter ablation . Am Heart J. 1987;; 114:1253-1258.
28 +
Miller J, Kienzle M, Harken A, Josephson M.  Subendocardial resection for ventricular tachycardia: predictors of surgical success . Circulation. 1984;;70:624-631.
29 +
Moran JM, Kehoe RF, Loeb JM, Lichtenthal PR, Sanders JH, Michaelis LL.  Extended endocardial resection for the treatment of ventricular tachycardia and ventricular fibrillation . Ann Thorac Surg. 1982;;34:538-552.
30 +
Saksena S.  Laser ablation for tachyarrhythmia control: current status and future developments . In: Brugada D, Wellens HJJ, eds. Cardiac Arrhythmias: Where to Go From Here? Mount Kisco, NY: Futura Publishing Co Inc; 1987;:803-819.
31 +
Guiraudon G, Fontaine G, Frank R, Cabral C, Grosgozeat Y.  Apport de la ventriculomie circulaire d'exclusion: dans le traitement de la tachycardie ventriculaire recidivante apres infartus du myocarde . Arch Mal Coeur. 1982;;75:1013-1020.
32 +
Ostermeyer J, Breithardt G, Borggrefe M, Godehardt E, Seipel L, Bircks W.  Surgical treatment of ventricular tachycardia: complete versus partial encircling endocardial ventriculotomy . J Thorac Cardiovasc Surg. 1984;;87:517-525.
33 +
Josephson ME, Harken AH, Horowitz LN.  Long-term results of endocardial resection for sustained ventricular tachycardia in coronary disease patients . Am Heart J. 1982;;104:51.
34 +
Hartzler GO.  Electrode catheter ablation of refractory focal ventricular tachycardia . J Am Coll Cardiol. 1983;;2:1107.
35 +
Davis JC, Finkebeiner W, Ruder MA, et al.  Histologic changes and arrhythmogenicity after discharge through transseptal catheter electrode . Circulation. 1986;;74:637-644.
36 +
Frank R, Fontaine G, Tonet JL, Grosgogeat Y.  Long-term experience of fulguration for the treatment of ventricular tachycardia . PACE. 1988;; 11:912.
37 +
Morady F, Scheinman MM, DiCarlo LA Jr, et al.  Catheter ablation of ventricular tachycardia with intracardiac shocks: results in 33 patients . Circulation. 1987;;75:1037-1049.
38 +
Haissaguerre M, Warin JF, Lemetayer P, Guillem JP, Blanchot P.  Catheter ablation of ventricular tachycardia using high cumulative energy: results in 28 patients with a mean follow-up of 27 months . PACE. 1988;;11:913.
39 +
Sellers TD, Dilorenzo D, Primerano P, et al.  Catheter ablation of resistant ventricular tachycardia: immediate results and long-term follow-up . PACE. 1988;;11:920.
40 +
Touboul P, Kirkorian G, Atallah G, et al.  Bundle branch reentrant tachycardia treated by electrical ablation of the right bundle branch . J Am Coll Cardiol. 1986;;7:1404-1409.
41 +
Wah Lai JY, Friday K, Olson E, Khan A, Prabhu S, Jackman W.  Selective percutaneous catheter ablation of the right bundle branch in patients with sustained bundle branch reentrant tachycardia . J Am Coll Cardiol. 1986;;7:243. Abstract.
42 +
Borggrefe M, Budde T, Podczeck A, Breithardt G.  High frequency alternating current ablation of an accessory pathway in humans . J Am Coll Cardiol. 1987;;10:576-582.
43 +
Cunningham D, Rowland E, Rickards A.  A new non-arcing electrode for catheter ablation: design and trial performance . Circulation . 1987;; 76(pt II, No. (4) ):IV-405. Abstract.
44 +
Guiraudon GM, Klein GJ, Sharma AD, Yee R.  Use of old and new anatomic, electrophysiologic and technical knowledge to develop operative approaches to tachycardia . In: Brugada D, Wellens HJJ, eds. Cardiac Arrhythmias: Where to Go From Here? Mount Kisco, NY: Futura Publishing Co Inc; 1987;:639-655.
45 +
Klein GJ, Guiraudon GM, Sharma AD, Milstein S.  Demonstration of macroreentry and feasibility of operative therapy in the common form of atrial flutter . Am J Cardiol. 1986;;57:587-591.

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