25. Catheter Ablation

  1. David H. Bennett MD FRCP

Published Online: 1 NOV 2012

DOI: 10.1002/9781118432389.ch25

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition

How to Cite

Bennett, D. H. (2013) Catheter Ablation, in Bennett's Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment, Eighth Edition, John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118432389.ch25

Author Information

  1. Senior Consultant Cardiologist, University Hospital of South Manchester, Manchester, UK

Publication History

  1. Published Online: 1 NOV 2012
  2. Published Print: 14 JAN 2013

ISBN Information

Print ISBN: 9780470674932

Online ISBN: 9781118432389

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Keywords:

  • Atrial fibrillation;
  • Atrial flutter;
  • Atrial tachycardia;
  • Atrioventricular nodal ablation;
  • Catheter ablation;
  • Normal sinus rhythm;
  • Right ventricular outflow tract tachycardia;
  • Typical atrioventricular nodal re-entrant tachycardia;
  • Ventricular tachycardia;
  • Wolff–Parkinson–White syndrome

Summary

Radiofrequency catheter ablation is a first-line treatment for supraventricular arrhythmias and for some ventricular tachycardias.

Atrioventricular (AV) nodal tachycardia is characterised by a very short ventriculoatrial conduction time: ablation of the AV nodal slow pathway is achieved by delivery of radiofrequency energy to a site close to the mouth of the coronary sinus. An accessory pathway, the cause of Wolff–Parkinson–White syndrome, is located by seeking the earliest site of ventricular activation during sinus rhythm or the earliest site of atrial activation during re-entrant tachycardia.

Pulmonary vein isolation techniques are effective at preventing paroxysmal atrial fibrillation. Atrial flutter is treated by ablating the isthmus of the right atrial re-entrant circuit that is located between the tricuspid valve and inferior vena cava. AV nodal ablation is effective in atrial arrhythmias that cannot be controlled: it necessitates pacemaker implantation.

Fascicular and right ventricular outflow tract ventricular tachycardias can be cured by ablation.