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Papers by J Tonet
Archives des maladies du coeur et des vaisseaux, 1989
Thirty one patients aged 56 +/- 16 years with chronic ventricular tachycardias (VT) refractory to... more Thirty one patients aged 56 +/- 16 years with chronic ventricular tachycardias (VT) refractory to 4.4 +/- 1.8 antiarrhythmic drugs, used alone or in combination, were managed by low doses of beta-blocker agents combined with oral amiodarone, either after loading (1.2 g for 7 days, n : 7) or reloading (1.2 g for 4 days, n : 24) of amiodarone. All patients proved refractory to amiodarone alone. Nine VT were also refractory to endocardial catheter fulguration in 8 patients. Twenty one patients had coronary artery disease, 4 had arrhythmogenic right ventricular dysplasia, 4 had dilated cardiomyopathy, 1 had valvular disease, and 1 had no structural heart disease. Twelve patients had an ejection fraction less than 30 p. 100. Ten patients were in NYHA functional class 3. VT was permanent in 3 patients, daily in 5, weekly in 7, paroxysmal in 16. In 14 patients, VT occurred both at day and night. Oral administration of a daily low dose of a beta-blocker agent (acebutolol 100 mg, betaxolol 5...
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Europace, 2010
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Archives of Cardiovascular Diseases Supplements
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Archives des maladies du coeur et des vaisseaux, 1996
Variations of temperature, impedance and power and the relationship between these three factors w... more Variations of temperature, impedance and power and the relationship between these three factors were studied in 20 patients during 351 applications of radiofrequency energy delivered by a generator with a regulated output power. The applications were divided into 3 groups according to the maximal temperature attained: group I (< 50 degrees C; n = 112), group II (50-60 degrees C; n = 100), and group III (60-70 degrees C; n = 139). Analysis of the total duration of time of applications (average +/- standard deviation) showed: the duration (seconds) was 23.9 +/- 11.9 seconds for group I, 36.1 +/- 18.7 seconds for group II and 45 +/- 23.6 seconds for group III. The time to attain maximal temperature was 6.8 +/- 9.6 seconds in group I, 11.7 +/- 12.7 in group II and 10 +/- 10.4 seconds in group III. The impedance remained under 200 omega in all applications, the target temperature being set at 70 degrees C. Analysis of the first three seconds of application: correlations coefficients b...
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Annales de cardiologie et d'angéiologie, 2005
ARVD manifests itself by a wide spectrum of clinical presentations from asymptomatic patients to ... more ARVD manifests itself by a wide spectrum of clinical presentations from asymptomatic patients to a broad range of ventricular arrhythmia, extrasystoles, tachycardia, or sudden arrhythmic death which can be the first symptom. It is a major cause for sudden death in young people and sportsmen. In known ARVD the risk of sudden death is not easy to assess from the literature, as its natural history is modulated by the wide variety of antiarrhythmic therapies. Hemodynamically ill tolerated ventricular arrhythmia, left ventricular involvement, sports, a youger age below 35, and uncontrolled therapy seem to predict an adverse outcome for these patients. These data may be helpful to decide for an AICD.
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Archives des maladies du coeur et des vaisseaux, 2002
Atrial flutter with 1/1 nodo-ventricular conduction is a classical complication of Vaughan-Willia... more Atrial flutter with 1/1 nodo-ventricular conduction is a classical complication of Vaughan-Williams's Class I antiarrhythmic drugs. The increase of the flutter cycle and weak action of the antiarrhythmic on the atrioventricular node leads to 1/1 conduction of atrial depolarisation to the ventricles. In view of their marked action on the atrioventricular node, this type of pro-arrhythmic effect is very unexpected with Class III antiarrhythmics. The authors report 7 cases of 1/1 atrial flutter with oral amiodarone observed between 1994 and 2001. The patients were 6 men and 1 woman with an average age of 58 +/- 14 years. Four of them had underlying cardiac disease; none were hyperthyroid. The initial arrhythmia was 2/1 atrial flutter (n = 4), 1/1 atrial flutter (n = 2) and atrial fibrillation (n = 1). Treatment was preventive with doses of 400 mg/day associated with carvedilol in one patient and 200 mg/day in another. The other five patients all received loading doses of 9200 +/- 2...
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Archives des maladies du coeur et des vaisseaux, 2000
The authors report the case of a young man with idiopathic ventricular tachycardia occurring in b... more The authors report the case of a young man with idiopathic ventricular tachycardia occurring in bursts and arising from the pulmonary infundibulum. During follow-up, progressive, severe, dilated cardiomyopathy was observed. Radiofrequency ablation of the site of origin of this very active arrhythmia resulted in total regression of the cardiomyopathy. Contrary to generally accepted concepts, paroxystic ventricular tachycardia, usually qualified as benign, may be complicated by cardiomyopathy when the ventricular extrasystole is incessant and repetitive.
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Annales de cardiologie et d'angéiologie, 1996
The combination of beta-blockers and amiodarone has been shown to be affective in the treatment o... more The combination of beta-blockers and amiodarone has been shown to be affective in the treatment of refractory chronic ventricular tachycardia. However, the possible induction of excessive sinus bradycardia can constitute a limitation to the use of this treatment. Celiprolol is a cardioselective beta-blocker with a partial beta-2 agonist activity and an alpha-2 blocking activity, with a minimal depressant effect on heart rate. It therefore seemed useful to evaluate this drug in combination with amiodarone in patients with chronic ventricular tachycardia refractory to amiodarone alone. Twelve men with age of 57 +/- 16 years (9 with a history of myocardial infarction) received 200 mg of celiprolol per day associated with an average of 2 grams of amiodarone per week. Failure of oral amiodarone alone was confirmed by "reloading" (1,200 mg per day for 4 days) in 11 patients. The mean left ventricular ejection fraction was 36 +/- 19%, and was < or = 30% in 5 patients. Three pa...
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Archives des maladies du coeur et des vaisseaux, 1995
The authors report 8 cases of regular tachycardia with wide QRS complexes during treatment with V... more The authors report 8 cases of regular tachycardia with wide QRS complexes during treatment with Vaughan-Williams class 1 antiarrhythmic drugs. These antiarrhythmics, prescribed to prevent atrial fibrillation (3 patients) and atrial flutter (5 patients), were flecainide in 4 cases, propafenone in 2 cases and cibenzoline and hydroquinidine respectively associated with digitoxine and propranolol. These wide complex tachycardias were regular atrial tachycardias with 1/1 conduction to the ventricle. The action of the drug, more pronounced on intra-atrial conduction velocities than on atrioventricular node refractoriness resulted in transformation of flutter at 300 cycles/min with 2/1 conduction and a ventricular rate of 150 cycles/min to atrial flutter at 210 cycles/min with 1/1 ventricular conduction. This acceleration of the ventricular rate was accompanied by widening of the QRS complex. Using the new ventricular tachycardia criteria recently published by Brugada resulted in a diagnos...
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Archivos del Instituto de Cardiología de México
Some factors related with successful radiofrequency catheter ablation were retrospectively analyz... more Some factors related with successful radiofrequency catheter ablation were retrospectively analyzed from the initial patients with WPW syndrome that underwent this therapy. They were 21 patients, and success rate with radiofrequency therapy was 73%. Conventional conduction intervals were obtained from catheter ablation electrograms. Only ventricular activation around Delta-wave onset, and earliest retrograde atrial activation were statistically significant for successful ablation (P < 0.05 both). Inadvertent interruption of AV-His bundle was produced ablating a septal accessory pathway, and no mortality procedure-related was observed. We conclude that radiofrequency catheter ablation of accessory pathways represents nowadays, an effective solution in patients with symptomatic arrhythmias, besides its high success rate and low risks, but different mapping criteria should be considered to attain an efficient elimination of atrioventricular accessory-pathways.
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Archives des maladies du coeur et des vaisseaux, 1993
The authors report the first case of arrhythmogenic right ventricular dysplasia presenting with a... more The authors report the first case of arrhythmogenic right ventricular dysplasia presenting with a sudden death due to primary ventricular fibrillation (ventricular fibrillation not preceded by ventricular tachycardia) recorded by the Holter method. The patient was a 56 year old man whose only complaint was near syncopal case is the fact that it is the first documented case of ventricular fibrillation revealing arrhythmogenic right ventricular dysplasia, the diagnosis of which was made at autopsy. In addition, the Holter recording showed the factors which triggered the arrhythmia: the "trigger" of 4 monomorphic ventricular extrasystoles during the minute preceding the ventricular fibrillation; the arrhythmogenic substrate giving rise to late ventricular potentials and, finally, the analysis of the R-R intervals suggesting a role of the sympathetic and parasympathetic nervous systems. Holter recordings could help identify subjects at high risk of severe ventricular arrhythmias.
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Annales de cardiologie et d'angéiologie, 1994
Right ventricular dysplasia may lead to sudden cardiac death an adolescent or adult with little o... more Right ventricular dysplasia may lead to sudden cardiac death an adolescent or adult with little or no symptoms. Identification of this condition in the high-risk population appears to be an objective to be attained in the near future. Thorough ECG analysis seems to be a non-invasive and inexpensive technique which could be used as a first approach for screening of the disorder. In a series of 50 cases of arrhythmogenic right ventricular dysplasia compared with a control group, the diagnosis of ARVD could be determined by ECG with 84% sensitivity and 100% specificity if QRS duration in leads V1, V2 or V3 was longer than 110 ms, T wave was negative in V2 or if T wave was negative in V1, but in this latter case only provided incomplete right bundle branch block was present.
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Archivos del Instituto de Cardiología de México
We present the immediate results and follow-up, from our initial serie of patients, where radiofr... more We present the immediate results and follow-up, from our initial serie of patients, where radiofrequency was attempted to ablate atrio-ventricular accessory pathways. Initiation policy included direct current-shocks following every unsuccessful radiofrequency session. Initial ablation success rate with radiofrequency solely was 75% (17/22), same as when direct current-shocks were associated 80% (8/10); but accessory pathway conduction recurrence was present only in this latter (6/10). During follow-up period of 18 to 25 months, from the recurrence group, one patient had spontaneous delta-wave disappearance, and four more required two to three ablation sessions. Permanent elimination with both methods was attained in 91% (20/22 pathways), and all patients remain asymptomatic, and drug free. There were one acute major complication, but no deaths. Because of its superior initial success rate, minor technical requirements, and their economical implications, radiofrequency catheter ablat...
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Archives des maladies du coeur et des vaisseaux, 1994
Eighty-nine cases of ventricular tachycardia, resistant to antiarrhythmic therapy, were treated o... more Eighty-nine cases of ventricular tachycardia, resistant to antiarrhythmic therapy, were treated over a 10 year period by high energy D ablation (fulguration). This series included 37 cases of myocardial infarction with a mean ejection fraction of 30%. The mean follow-up period of the survivors was 61 months and clinical efficacy was 87.9%. Twenty-three cases of arrhythmogenic right ventricular dysplasia, aged 40 years, and with an ejection fraction of 57%, followed up for 71 months, had a clinical efficacy of 83%. Twelve patients had verapamil sensitive (fascicular) ventricular tachycardia. Their age was 30, their ejection fraction 65%, the follow-up period 55 months, and the clinical efficacy was 100%. Ten patients had primary dilated cardiomyopathy. Their age was 35, their ejection fraction 23%, the follow-up period of 38 months with a clinical efficacy of 80%. Four patients, aged 21, had operated congenital heart disease with an ejection fraction of 60%, a follow-up of 36 months ...
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Archives of medical research, 1995
Idiopathic ventricular tachycardia is a well described syndrome of both left and right ventricula... more Idiopathic ventricular tachycardia is a well described syndrome of both left and right ventricular origin. This study reports the feasibility and efficacy of catheter ablation in this entity. Fourteen patients (mean age 30 +/- 10 years of age) and six patients (mean age 51 +/- 9 years of age) underwent endocardial catheter ablation with either direct-current shocks and radiofrequency energy, respectively. Earliest right and left ventricular activation and endocardial mapping during tachycardia were made to localize the site of ventricular tachycardia origin. The overall clinical efficacy was 93% for direct-current method with a mean number of shocks of 3.3 +/- 0.9/patient after a mean follow-up of 38 +/- 25 months. Radiofrequency ablation achieved an overall clinical efficacy of 83.6% with a mean of 3.2 pulses/patient during a follow-up of 10.5 +/- 4 months. The isoenzyme MB fraction of peak creatine kinase after ablation was less than 5%. There were no complications in any patient ...
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Archivos del Instituto de Cardiología de México
A case is presented of symptomatic premature ventricular contractions refractory to drug therapy ... more A case is presented of symptomatic premature ventricular contractions refractory to drug therapy with right bundle branch block QRS morphology and left axis deviation in a 68-year-old female without structural heart disease. Endocardial mapping localized the extrasystolic focus at meso-inferoapical region of the left ventricular septum suggesting an origin from the Purkinje network of the left posterior fascicle. Catheter ablation with direct-current energy abolished extrasystolic complexes, without complications. The patient remained asymptomatic over a follow-up of 3 months.
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Archives des maladies du coeur et des vaisseaux, 1981
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Revista clínica española, 1987
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Archives des maladies du coeur et des vaisseaux, 1988
Forty-four patients with ventricular tachycardias (VT) refractory to medical treatment underwent ... more Forty-four patients with ventricular tachycardias (VT) refractory to medical treatment underwent 73 sessions of endocavitary electrode catheter ablation. The clinical series included 16 cases of post-infarction VT, 14 cases of arrhythmogenic right ventricular dysplasia, 6 cases of dilated cardiomyopathy, 6 cases of idiopathic VT, 1 case of sequela of myocarditis and 1 case of VT consecutive to surgical repair of a congenital cardiopathy. Cardiomegaly was present in 30 patients, and 16 patients had an ejection fraction of less than 30 p. 100. None of the patients were receiving digitalis or class I antiarrhythmic drugs when ablation was performed. A total of 235 shocks of 100 to 320 J (mean 221 +/- 42 J) were delivered. 115 shocks (49 p. 100) were complicated by dysrhythmia and/or disorders of conduction; 29 shocks (12 p. 100) induced 13 ventricular fibrillations and 16 ventricular tachycardias. No relation was found between energy delivered, shock synchronization, haemodynamic statu...
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Archivos del Instituto de Cardiología de México
Between 1983 and 1989, 69 patients underwent endocardial fulguration for drug-resistant VT which ... more Between 1983 and 1989, 69 patients underwent endocardial fulguration for drug-resistant VT which had several relapses per month, or were incessant. The etiologies were an old myocardial infarction, (25 cases) arrhythmogenic right ventricular dysplasia, (19 cases) dilated cardiomyocathy, (9 cases) left fascicular tachycardia, (9 cases) 5 right septal idiopathic tachycardia, and 2 congenital heart disease. The ejection fraction ranged between 12 and 30% in 25 cases. VT originated in 32 patients in the right ventricle, 31 in the left, and 6 had fulguration in both ventricles. 41 patients had 1 session, 22 needed 2, 4 had three sessions and 2 had 4. Five patients died during the procedure, four of low output, and three of them before the shocks. One died of tamponade. Two others had tamponade and were successfully drained. Four patients died during the first 3 months of preexisting heart failure without VT relapse. The remaining patients have a mean follow-up of 32 months, ranging from ...
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Archives des maladies du coeur et des vaisseaux, 1989
Thirty one patients aged 56 +/- 16 years with chronic ventricular tachycardias (VT) refractory to... more Thirty one patients aged 56 +/- 16 years with chronic ventricular tachycardias (VT) refractory to 4.4 +/- 1.8 antiarrhythmic drugs, used alone or in combination, were managed by low doses of beta-blocker agents combined with oral amiodarone, either after loading (1.2 g for 7 days, n : 7) or reloading (1.2 g for 4 days, n : 24) of amiodarone. All patients proved refractory to amiodarone alone. Nine VT were also refractory to endocardial catheter fulguration in 8 patients. Twenty one patients had coronary artery disease, 4 had arrhythmogenic right ventricular dysplasia, 4 had dilated cardiomyopathy, 1 had valvular disease, and 1 had no structural heart disease. Twelve patients had an ejection fraction less than 30 p. 100. Ten patients were in NYHA functional class 3. VT was permanent in 3 patients, daily in 5, weekly in 7, paroxysmal in 16. In 14 patients, VT occurred both at day and night. Oral administration of a daily low dose of a beta-blocker agent (acebutolol 100 mg, betaxolol 5...
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Europace, 2010
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Archives of Cardiovascular Diseases Supplements
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Archives des maladies du coeur et des vaisseaux, 1996
Variations of temperature, impedance and power and the relationship between these three factors w... more Variations of temperature, impedance and power and the relationship between these three factors were studied in 20 patients during 351 applications of radiofrequency energy delivered by a generator with a regulated output power. The applications were divided into 3 groups according to the maximal temperature attained: group I (< 50 degrees C; n = 112), group II (50-60 degrees C; n = 100), and group III (60-70 degrees C; n = 139). Analysis of the total duration of time of applications (average +/- standard deviation) showed: the duration (seconds) was 23.9 +/- 11.9 seconds for group I, 36.1 +/- 18.7 seconds for group II and 45 +/- 23.6 seconds for group III. The time to attain maximal temperature was 6.8 +/- 9.6 seconds in group I, 11.7 +/- 12.7 in group II and 10 +/- 10.4 seconds in group III. The impedance remained under 200 omega in all applications, the target temperature being set at 70 degrees C. Analysis of the first three seconds of application: correlations coefficients b...
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Annales de cardiologie et d'angéiologie, 2005
ARVD manifests itself by a wide spectrum of clinical presentations from asymptomatic patients to ... more ARVD manifests itself by a wide spectrum of clinical presentations from asymptomatic patients to a broad range of ventricular arrhythmia, extrasystoles, tachycardia, or sudden arrhythmic death which can be the first symptom. It is a major cause for sudden death in young people and sportsmen. In known ARVD the risk of sudden death is not easy to assess from the literature, as its natural history is modulated by the wide variety of antiarrhythmic therapies. Hemodynamically ill tolerated ventricular arrhythmia, left ventricular involvement, sports, a youger age below 35, and uncontrolled therapy seem to predict an adverse outcome for these patients. These data may be helpful to decide for an AICD.
Bookmarks Related papers MentionsView impact
Archives des maladies du coeur et des vaisseaux, 2002
Atrial flutter with 1/1 nodo-ventricular conduction is a classical complication of Vaughan-Willia... more Atrial flutter with 1/1 nodo-ventricular conduction is a classical complication of Vaughan-Williams's Class I antiarrhythmic drugs. The increase of the flutter cycle and weak action of the antiarrhythmic on the atrioventricular node leads to 1/1 conduction of atrial depolarisation to the ventricles. In view of their marked action on the atrioventricular node, this type of pro-arrhythmic effect is very unexpected with Class III antiarrhythmics. The authors report 7 cases of 1/1 atrial flutter with oral amiodarone observed between 1994 and 2001. The patients were 6 men and 1 woman with an average age of 58 +/- 14 years. Four of them had underlying cardiac disease; none were hyperthyroid. The initial arrhythmia was 2/1 atrial flutter (n = 4), 1/1 atrial flutter (n = 2) and atrial fibrillation (n = 1). Treatment was preventive with doses of 400 mg/day associated with carvedilol in one patient and 200 mg/day in another. The other five patients all received loading doses of 9200 +/- 2...
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Archives des maladies du coeur et des vaisseaux, 2000
The authors report the case of a young man with idiopathic ventricular tachycardia occurring in b... more The authors report the case of a young man with idiopathic ventricular tachycardia occurring in bursts and arising from the pulmonary infundibulum. During follow-up, progressive, severe, dilated cardiomyopathy was observed. Radiofrequency ablation of the site of origin of this very active arrhythmia resulted in total regression of the cardiomyopathy. Contrary to generally accepted concepts, paroxystic ventricular tachycardia, usually qualified as benign, may be complicated by cardiomyopathy when the ventricular extrasystole is incessant and repetitive.
Bookmarks Related papers MentionsView impact
Annales de cardiologie et d'angéiologie, 1996
The combination of beta-blockers and amiodarone has been shown to be affective in the treatment o... more The combination of beta-blockers and amiodarone has been shown to be affective in the treatment of refractory chronic ventricular tachycardia. However, the possible induction of excessive sinus bradycardia can constitute a limitation to the use of this treatment. Celiprolol is a cardioselective beta-blocker with a partial beta-2 agonist activity and an alpha-2 blocking activity, with a minimal depressant effect on heart rate. It therefore seemed useful to evaluate this drug in combination with amiodarone in patients with chronic ventricular tachycardia refractory to amiodarone alone. Twelve men with age of 57 +/- 16 years (9 with a history of myocardial infarction) received 200 mg of celiprolol per day associated with an average of 2 grams of amiodarone per week. Failure of oral amiodarone alone was confirmed by "reloading" (1,200 mg per day for 4 days) in 11 patients. The mean left ventricular ejection fraction was 36 +/- 19%, and was < or = 30% in 5 patients. Three pa...
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Archives des maladies du coeur et des vaisseaux, 1995
The authors report 8 cases of regular tachycardia with wide QRS complexes during treatment with V... more The authors report 8 cases of regular tachycardia with wide QRS complexes during treatment with Vaughan-Williams class 1 antiarrhythmic drugs. These antiarrhythmics, prescribed to prevent atrial fibrillation (3 patients) and atrial flutter (5 patients), were flecainide in 4 cases, propafenone in 2 cases and cibenzoline and hydroquinidine respectively associated with digitoxine and propranolol. These wide complex tachycardias were regular atrial tachycardias with 1/1 conduction to the ventricle. The action of the drug, more pronounced on intra-atrial conduction velocities than on atrioventricular node refractoriness resulted in transformation of flutter at 300 cycles/min with 2/1 conduction and a ventricular rate of 150 cycles/min to atrial flutter at 210 cycles/min with 1/1 ventricular conduction. This acceleration of the ventricular rate was accompanied by widening of the QRS complex. Using the new ventricular tachycardia criteria recently published by Brugada resulted in a diagnos...
Bookmarks Related papers MentionsView impact
Archivos del Instituto de Cardiología de México
Some factors related with successful radiofrequency catheter ablation were retrospectively analyz... more Some factors related with successful radiofrequency catheter ablation were retrospectively analyzed from the initial patients with WPW syndrome that underwent this therapy. They were 21 patients, and success rate with radiofrequency therapy was 73%. Conventional conduction intervals were obtained from catheter ablation electrograms. Only ventricular activation around Delta-wave onset, and earliest retrograde atrial activation were statistically significant for successful ablation (P < 0.05 both). Inadvertent interruption of AV-His bundle was produced ablating a septal accessory pathway, and no mortality procedure-related was observed. We conclude that radiofrequency catheter ablation of accessory pathways represents nowadays, an effective solution in patients with symptomatic arrhythmias, besides its high success rate and low risks, but different mapping criteria should be considered to attain an efficient elimination of atrioventricular accessory-pathways.
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Archives des maladies du coeur et des vaisseaux, 1993
The authors report the first case of arrhythmogenic right ventricular dysplasia presenting with a... more The authors report the first case of arrhythmogenic right ventricular dysplasia presenting with a sudden death due to primary ventricular fibrillation (ventricular fibrillation not preceded by ventricular tachycardia) recorded by the Holter method. The patient was a 56 year old man whose only complaint was near syncopal case is the fact that it is the first documented case of ventricular fibrillation revealing arrhythmogenic right ventricular dysplasia, the diagnosis of which was made at autopsy. In addition, the Holter recording showed the factors which triggered the arrhythmia: the "trigger" of 4 monomorphic ventricular extrasystoles during the minute preceding the ventricular fibrillation; the arrhythmogenic substrate giving rise to late ventricular potentials and, finally, the analysis of the R-R intervals suggesting a role of the sympathetic and parasympathetic nervous systems. Holter recordings could help identify subjects at high risk of severe ventricular arrhythmias.
Bookmarks Related papers MentionsView impact
Annales de cardiologie et d'angéiologie, 1994
Right ventricular dysplasia may lead to sudden cardiac death an adolescent or adult with little o... more Right ventricular dysplasia may lead to sudden cardiac death an adolescent or adult with little or no symptoms. Identification of this condition in the high-risk population appears to be an objective to be attained in the near future. Thorough ECG analysis seems to be a non-invasive and inexpensive technique which could be used as a first approach for screening of the disorder. In a series of 50 cases of arrhythmogenic right ventricular dysplasia compared with a control group, the diagnosis of ARVD could be determined by ECG with 84% sensitivity and 100% specificity if QRS duration in leads V1, V2 or V3 was longer than 110 ms, T wave was negative in V2 or if T wave was negative in V1, but in this latter case only provided incomplete right bundle branch block was present.
Bookmarks Related papers MentionsView impact
Archivos del Instituto de Cardiología de México
We present the immediate results and follow-up, from our initial serie of patients, where radiofr... more We present the immediate results and follow-up, from our initial serie of patients, where radiofrequency was attempted to ablate atrio-ventricular accessory pathways. Initiation policy included direct current-shocks following every unsuccessful radiofrequency session. Initial ablation success rate with radiofrequency solely was 75% (17/22), same as when direct current-shocks were associated 80% (8/10); but accessory pathway conduction recurrence was present only in this latter (6/10). During follow-up period of 18 to 25 months, from the recurrence group, one patient had spontaneous delta-wave disappearance, and four more required two to three ablation sessions. Permanent elimination with both methods was attained in 91% (20/22 pathways), and all patients remain asymptomatic, and drug free. There were one acute major complication, but no deaths. Because of its superior initial success rate, minor technical requirements, and their economical implications, radiofrequency catheter ablat...
Bookmarks Related papers MentionsView impact
Archives des maladies du coeur et des vaisseaux, 1994
Eighty-nine cases of ventricular tachycardia, resistant to antiarrhythmic therapy, were treated o... more Eighty-nine cases of ventricular tachycardia, resistant to antiarrhythmic therapy, were treated over a 10 year period by high energy D ablation (fulguration). This series included 37 cases of myocardial infarction with a mean ejection fraction of 30%. The mean follow-up period of the survivors was 61 months and clinical efficacy was 87.9%. Twenty-three cases of arrhythmogenic right ventricular dysplasia, aged 40 years, and with an ejection fraction of 57%, followed up for 71 months, had a clinical efficacy of 83%. Twelve patients had verapamil sensitive (fascicular) ventricular tachycardia. Their age was 30, their ejection fraction 65%, the follow-up period 55 months, and the clinical efficacy was 100%. Ten patients had primary dilated cardiomyopathy. Their age was 35, their ejection fraction 23%, the follow-up period of 38 months with a clinical efficacy of 80%. Four patients, aged 21, had operated congenital heart disease with an ejection fraction of 60%, a follow-up of 36 months ...
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Archives of medical research, 1995
Idiopathic ventricular tachycardia is a well described syndrome of both left and right ventricula... more Idiopathic ventricular tachycardia is a well described syndrome of both left and right ventricular origin. This study reports the feasibility and efficacy of catheter ablation in this entity. Fourteen patients (mean age 30 +/- 10 years of age) and six patients (mean age 51 +/- 9 years of age) underwent endocardial catheter ablation with either direct-current shocks and radiofrequency energy, respectively. Earliest right and left ventricular activation and endocardial mapping during tachycardia were made to localize the site of ventricular tachycardia origin. The overall clinical efficacy was 93% for direct-current method with a mean number of shocks of 3.3 +/- 0.9/patient after a mean follow-up of 38 +/- 25 months. Radiofrequency ablation achieved an overall clinical efficacy of 83.6% with a mean of 3.2 pulses/patient during a follow-up of 10.5 +/- 4 months. The isoenzyme MB fraction of peak creatine kinase after ablation was less than 5%. There were no complications in any patient ...
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Archivos del Instituto de Cardiología de México
A case is presented of symptomatic premature ventricular contractions refractory to drug therapy ... more A case is presented of symptomatic premature ventricular contractions refractory to drug therapy with right bundle branch block QRS morphology and left axis deviation in a 68-year-old female without structural heart disease. Endocardial mapping localized the extrasystolic focus at meso-inferoapical region of the left ventricular septum suggesting an origin from the Purkinje network of the left posterior fascicle. Catheter ablation with direct-current energy abolished extrasystolic complexes, without complications. The patient remained asymptomatic over a follow-up of 3 months.
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Archives des maladies du coeur et des vaisseaux, 1981
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Revista clínica española, 1987
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Archives des maladies du coeur et des vaisseaux, 1988
Forty-four patients with ventricular tachycardias (VT) refractory to medical treatment underwent ... more Forty-four patients with ventricular tachycardias (VT) refractory to medical treatment underwent 73 sessions of endocavitary electrode catheter ablation. The clinical series included 16 cases of post-infarction VT, 14 cases of arrhythmogenic right ventricular dysplasia, 6 cases of dilated cardiomyopathy, 6 cases of idiopathic VT, 1 case of sequela of myocarditis and 1 case of VT consecutive to surgical repair of a congenital cardiopathy. Cardiomegaly was present in 30 patients, and 16 patients had an ejection fraction of less than 30 p. 100. None of the patients were receiving digitalis or class I antiarrhythmic drugs when ablation was performed. A total of 235 shocks of 100 to 320 J (mean 221 +/- 42 J) were delivered. 115 shocks (49 p. 100) were complicated by dysrhythmia and/or disorders of conduction; 29 shocks (12 p. 100) induced 13 ventricular fibrillations and 16 ventricular tachycardias. No relation was found between energy delivered, shock synchronization, haemodynamic statu...
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Archivos del Instituto de Cardiología de México
Between 1983 and 1989, 69 patients underwent endocardial fulguration for drug-resistant VT which ... more Between 1983 and 1989, 69 patients underwent endocardial fulguration for drug-resistant VT which had several relapses per month, or were incessant. The etiologies were an old myocardial infarction, (25 cases) arrhythmogenic right ventricular dysplasia, (19 cases) dilated cardiomyocathy, (9 cases) left fascicular tachycardia, (9 cases) 5 right septal idiopathic tachycardia, and 2 congenital heart disease. The ejection fraction ranged between 12 and 30% in 25 cases. VT originated in 32 patients in the right ventricle, 31 in the left, and 6 had fulguration in both ventricles. 41 patients had 1 session, 22 needed 2, 4 had three sessions and 2 had 4. Five patients died during the procedure, four of low output, and three of them before the shocks. One died of tamponade. Two others had tamponade and were successfully drained. Four patients died during the first 3 months of preexisting heart failure without VT relapse. The remaining patients have a mean follow-up of 32 months, ranging from ...
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