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Regression of coronary atherosclerosis: A prospective, quantitative angiographic study
JACC V&d. 17. No. 2 February 19933231A
lesions (k
= stenoses 2 20% or occlusions) apart from ses ,gr r q, 5 E (Gr ng, hyperchkesterinemia, ressing stenoses (2 20%; PRO) lesions (ML) seen at 2. CA are
S
lanation sents
either of
for
regression “true” lesions regress
these or in
findi measurement 2 years.
error.
speed bf future progression. Pts with a on should he followed up closely and for reangiography. 2) The no. of classical risk factors is not different between pts with a hiah or low progression rate during 3 years.
MEW’ FOR RADIOFREQUENCY ABLA411OM OF ANTEROSEPTAL ACCESSORY PATHWAYS. Nicholas Twidale, Xunzhang Wang, Kriegh Moulton, Uaren Beckmanp Michael Prior, Andrew Hazlitt, Ralph Lazzaia, Warren Jackman. Univ. of Oklahoma and VAHC, Oklahoma City, OK. Catheter ablation of anteroseptal (AS) accessory pathways (AP) may be complicated by AW block. Believing the His bundle (H), surrounded by fibrous tissue, to be more resistant to injury than the AV node, radiof requency energy (RF) was appl i ed to the ventricular (V) side of the tricuspid (T) anulus in 8 patients (pts) with AS APs. APs were defined as AS if both AP and H potentials were recorded from the same 2 AP conducted only mm-spaced bipolar electrode. A 7F catheter with a 4 mm large retrogradely in 2 pts. tip electrode (LTE) was inserted via a subclavian vein, advanced into the right V, curved 180” and withdrawn beneath the T leaflet until the LTE was held firmly against the T anulus and recorded AP potential. RF (32&6 Watts for 41i18 set) applied to the LTE In the remaining eliminated AP conduction in 6/8 pts. 2 pts, AP conduction was eliminated by RF (25&l Watts for 33i38 set) delivered through a LTE positioned parallel to the H catheter and recording AP potential. Of 6 pts with antegrade AP conduction, preexcitation and reentrant tachycardia (RT) have not returned in In the 2 pts with concealed BPS, 4i~6 mths of followup. AP conduction and RT recurred but AP was successfully re-ablated 2 wks and7mthsfollowing the original right bundle branch block was procedure . Al though produced in 5 pts, block distal to H did not occur during atrial pacing and 1:l AV nodal conduction was preserved (352*64ms pre, 310*55ms post-ablation). We conclude: 1) APs in close proximity to H can be ablated by RF with low risk of AV block; 2) placement beneath T leaflet ensures W location and firm contact.
lesions (k
= stenoses 2 20% or occlusions) apart from ses ,gr r q, 5 E (Gr ng, hyperchkesterinemia, ressing stenoses (2 20%; PRO) lesions (ML) seen at 2. CA are
S
lanation sents
either of
for
regression “true” lesions regress
these or in
findi measurement 2 years.
error.
speed bf future progression. Pts with a on should he followed up closely and for reangiography. 2) The no. of classical risk factors is not different between pts with a hiah or low progression rate during 3 years.
MEW’ FOR RADIOFREQUENCY ABLA411OM OF ANTEROSEPTAL ACCESSORY PATHWAYS. Nicholas Twidale, Xunzhang Wang, Kriegh Moulton, Uaren Beckmanp Michael Prior, Andrew Hazlitt, Ralph Lazzaia, Warren Jackman. Univ. of Oklahoma and VAHC, Oklahoma City, OK. Catheter ablation of anteroseptal (AS) accessory pathways (AP) may be complicated by AW block. Believing the His bundle (H), surrounded by fibrous tissue, to be more resistant to injury than the AV node, radiof requency energy (RF) was appl i ed to the ventricular (V) side of the tricuspid (T) anulus in 8 patients (pts) with AS APs. APs were defined as AS if both AP and H potentials were recorded from the same 2 AP conducted only mm-spaced bipolar electrode. A 7F catheter with a 4 mm large retrogradely in 2 pts. tip electrode (LTE) was inserted via a subclavian vein, advanced into the right V, curved 180” and withdrawn beneath the T leaflet until the LTE was held firmly against the T anulus and recorded AP potential. RF (32&6 Watts for 41i18 set) applied to the LTE In the remaining eliminated AP conduction in 6/8 pts. 2 pts, AP conduction was eliminated by RF (25&l Watts for 33i38 set) delivered through a LTE positioned parallel to the H catheter and recording AP potential. Of 6 pts with antegrade AP conduction, preexcitation and reentrant tachycardia (RT) have not returned in In the 2 pts with concealed BPS, 4i~6 mths of followup. AP conduction and RT recurred but AP was successfully re-ablated 2 wks and7mthsfollowing the original right bundle branch block was procedure . Al though produced in 5 pts, block distal to H did not occur during atrial pacing and 1:l AV nodal conduction was preserved (352*64ms pre, 310*55ms post-ablation). We conclude: 1) APs in close proximity to H can be ablated by RF with low risk of AV block; 2) placement beneath T leaflet ensures W location and firm contact.