Atrioventricular reentrant tachycardia ablation performed via patent foramen ovale

Abstract

Objective To evaluate the possibility and safety of left accessory pathway ablation from the patent foramen ovale.Methods From January 2008 to March 2009,a total of 41 patients with left atrioventricular reentrant tachycardia patients(mean age 47.0 ± 16.8 years) received radiofrequency ablation.After confirmed the left side of the bypass by electrophysiological examination,all patients were received first test the existence of patent foramen ovale with the catheter probe.After confirmed the left accessory pathway,the patients were ablated through the patent foramen ovale,while the remaining patients underwent RFCA via the transfemoral approach(controls) .These two methods were compared with the ablation success rate,the total procedure time,the fluoroscopic time and the occurrence of side effects.After 3-18 months,all patients received telephone follow-up.Results All patients had successful ablation,of which 11 patients ablated from patent foramen ovale and the remaining 30 patients via the right femoral artery approach.In control group,5 patients suffered from hematoma in puncture site and 1 case suffered from acute cardiac tamponade during ablation.She was received second RFCA via transseptal approach 20 days after the fist procedure.The total procedure time was 56.3 ± 14.2 min vs.60.3 ± 18.2 min,P = 0.076;the fluoroscopic time was 9.1 ± 3.9 min vs.9.5 ± 4.2 min,P = 0.115.To detect the existence of the foramen ovale required additional 4.7 ± 1.2 min.There was no recurrence of arrhythmia in either group during follow up.Neither cerebral infarction,embolism,nor migraine headache were detected during the follow up.Conclusions The left-sided Aps ablation performed via patent foramen ovale is simple,fast and safe.It's worth to test the existence of the patent foramen ovale before the left-sided APs ablation.