Radiofrequency catheter ablation of accessory pathways related to the Wolff-Parkinson-White
(WPW) syndrome has become the treatment of choice for symptomatic patients. The retrograde
and the transseptal approaches are comparable and standard for addressing left-sided
pathways.
1
,
2
Cardiac tamponade due to perforation of the left atrial free wall is among the complications
of the transseptal approach, with
3
or without
4
,
5
,
6
echocardiographic guidance. This complication requires immediate drainage by needle
aspiration
7
,
8
,
9
,
10
or surgery.
11
,
These are often used with placement of an intrapericardial sheath or catheter for
continuing drainage.
8
,
11
These interventions are effective, but psychologically unpalatable to patient and
physician alike. This article reports an alternative internal drainage method that
is psychologically atraumatic to the patient, and has been followed by successful
ablation within the next 24 hours with an overall satisfactory outcome.To read this article in full you will need to make a payment
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References
- Comparison of the retrograde and transseptal methods for ablation of left freewall accessory pathways.J Am Coll Cardiol. 1993; 22: 542-549
- Ablation of left free-wall accessory pathways using radiofrequency energy at the atrial insertion site.J Cardiovasc Electrophysiol. 1994; 5: 219-231
- Transesophageal echocardiographically guided atrial transseptal catheterization in patients with normal-sized atria.Clin Cardiol. 1995; 18: 217-220
- The technique and safety of transseptal left heart catheterization.Cathet Cardiovasc Diagn. 1994; 32: 332-339
- Radiofrequency endocardial catheter ablation of accessory atrioventricular pathway atrial insertion sites.Circulation. 1993; 87: 487-499
Clugston R, Lau FY, Ruiz C. Transseptal catheterization update 1992. Cathet Cardiovasc Diagn 1992;26:266–274.
- Rescue echocardiographically guided pericardiocentesis for cardiac perforation complicating catheter-based procedures. The Mayo Clinic experience.J Am Coll Cardiol. 1998; 32: 1345-1350
- Cardiac tamponade.Postgrad Med J. 1997; 73: 141-145
- Pericardial effusion and tamponade.Compr Ther. 1995; 21: 378-385
- Myocardial perforation in the cardiac catheterization laboratory.Cathet Cardiovasc Diagn. 1994; 32: 99-107
- Percutaneous pericardiocentesis versus subxiphoid pericardiotomy in cardiac tamponade due to postoperative pericardial effusion.J Cardiothorac Vasc Anesth. 1993; 7: 178-183
- Transseptal Technique A Workbook. Futura, Mount Kisco, NY1989: 13-23
- Cardiac Catheterization and Angiography. Lea & Febiger, Philadelphia, PA1986: 71-75
Article Info
Publication History
Accepted:
June 29,
2000
Received in revised form:
June 29,
2000
Received:
April 5,
2000
Identification
Copyright
© 2000 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
