A Comparison Study between the Trans-Septal and the Trans-Aortic Approaches in Left Sided Accessory Pathway Ablation in Ibn Albitar Cardiac Center | ||
| Iraqi Postgraduate Medical Journal | ||
| Article 3, Volume 19, Issue 2, June 2020, Pages 97-102 PDF (0 K) | ||
| Authors | ||
| Khalil Sarhan Khalaf; Mohammed Ameen Kadhum; Hayder Riyadh Alkahachi; Khalil Sarhan Khalaf; Mohammed Ameen Kadhum; Hayder Riyadh Alkahachi | ||
| Abstract | ||
| ABSTRACT: BACKGROUND: Catheter ablation is the most effective treatment for patients with accessory pathway-related arrhythmias. There have been no clear recommendations on the optimal approach for left-sided accessory pathway ablation. OBJECTIVE: To compare the efficacy and safety of the trans-septal approach versus the retrograde trans-aortic approach for left sided accessory pathway ablation. PATIENTS AND METHODS: All patients with left-sided, accessory pathway who underwent electrophysiological procedure and radiofrequency ablations in Ibn Albitar Cardiac center from January 2017 till February 2019 were included (79 patients). The procedures (87 procdures) were divided according to the approach used into the trans-septal and trans-aortic groups, and different parameters were measured and compared between the groups. RESULTS: The mean age was 36.28±13.5 (range 8-67) years, male gender was slightly more predominant (58.2%). The trans-aortic approach was pursued in 36 procedures (41.4%), while the trans-septal approach was used in 51 procedures (58.6%). The success rate was significantly better with the trans-septal approach (96.1%) than with the transaortic one (66.7%) p=0.0002, other parameters that showed significant differences including the procedure time and fluoroscopic time in favor of the trans-septal approach. While the number of ablations, the presence of accessory pathway potential, and the time needed for successful ablation at the target sites showed no significant difference between the two approaches. Complications were generally low and were recorded in 3 patients (3.4%) ; 2 pericardial effusion and one deep vein thrombosis. CONCLUSION: There was a higher success rate with the left-sided, accessory pathway ablation then with the transseptal approach as compared to the traditional retrograde trans-aortic approach with similar safety profile. | ||
| Keywords | ||
| Radiofrequency RF Ablation; Accessory pathway ablation; Trans; septal approach; aortic approach; Electrophysiology EP Study | ||
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