Biomedical Engineering Reference
In-Depth Information
A
B
(a)
Tachyarrhythmias
AP
current
AVNRT
current
AVJ
current
Atrial flutter
current
Atrial fibrillation
current
VT
current
(b)
FIGURE 6.10
(
a
) Accessory pathways: A, premature impulse blocks antegradely in
bypass tract; B, reentrant impulse established. (
b
) RF catheter ablation is the therapy
of choice.
electrical cardioversion resulted in complete AV block; this occurred when the
defibrillator was accidentally discharged through the bundle of His. The first
human catheter ablations were performed in 1981 using direct current [13-16].
The problems occuring during DC ablation propelled the idea of RF ablation
in 1988. The first RF catheter ablation was performed in men by Lumberg [40,
41]. Currently RF ablation is routinely used to treat atrioventricular junction
(AVJ), accessory pathway (AP), AVNRT, and some types of ventricular
tachycardia.
General anasthesia is not required during RF ablation, and there is no risk
of barotrauma (Fig. 6.12). The success of RF ablation is based on the fact that
it is a relatively easy procedure (when compared with surgery), during which
a steerable catheter is advanced toward the target tissue and controlled, dis-
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