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Left Ventricular Function Need Not Be Affected By Multiple Radio Frequency Ablation
A DGReview of :"Effect of radiofrequency catheter ablation of ventricular tachycardia on left ventricular function in patients with prior myocardial infarction."
Journal of Interventional Cardiac Electrophysiology
01/09/2003
By Harvey McConnell
Left ventricular function among patients with a prior myocardial infarction is not significantly affected by multiple radio frequency catheter ablation if the lesions are confined to the area of the infarct.
Doctors should, however, adopt a cautious approach in using the technique by confining ablation lesions to areas of scar, say clinicians at the Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States. Their conclusions are based on a study among 55 men and 7 women, average age 67, who had radio frequency (RF) ablation for ventricular tachycardia (VT) late after myocardial infarction (MI).
The clinicians point out that RF ablation of VT late after MI can be a successful intervention but, it involves multiple applications and results in long lines of lesions. Although the impact on left ventricular function is potentially important, it is not well defined.
Among the 62 patients, left ventricular ejection fraction (LVEF) was quantified from digital echocardiograms which was carried out within a week before, and less than 72 hours after, ablation. Patients received a mean of 25.6 RF lesions.
The clinicians found that the LVEF, both before and after ablation, did not differ for the group, nor for the 30 patients who received more than 25 RF lesions, nor for the 7 who received more than 40 RF lesions. Although LVEF did not change for the group measured as a whole, it did increase by more than 5% among 12 patients (19.4% ), and decreased at least 5%, or higher, among 14 patients (22.5%).
Patients with a decrease in ejection function did not differ from the remaining patients in age, sex, number of RF lesions, or use of a cooled RF catheter. On the other hand, they did have a better initial ejection function.
J Interv Card Electrophysiol 2002 Dec;7(3):243-7.
"Effect of radiofrequency catheter ablation of ventricular tachycardia on left ventricular function in patients with prior myocardial infarction."
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