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Biomedical subjects

A Garrido

Publications and source records attributed to A Garrido.

114 records · Page 7Linked to original sources
PubMedDate not supplied

[Radiofrequency ablation in tachycardias due to accessory pathways in a pediatric population].

Catheter ablation of accessory atrioventricular pathways using radiofrequency current was attempted in 61 children and young adolescents less than 18 years of age who were referred for treatment of symptomatic supraventricular tachycardia. Thirty-three children had the Wolff-Parkinson-White syndrome and 30 tachyarrhythmias related to an accessory pathway conducting only in retrograde fashion. Ablation of left sided accessory pathways was usually attempted utilizing an arterial approach to the annulus of the mitral valve, only in one case we used the transseptal approach, while the venous route to the atrial aspect of the tricuspid valvular annulus was chosen for right sided accessory connections. Ablation of 55 of 63 accessory connections was achieved (87% success) with a range of 1 to 42 applications of radiofrequency current. The sessions were completed within 19 to 180 minutes, and we used within 16 to 45 watts of radiofrequency current. Two patients had complications as a result of their ablation procedure. One patient had complete heart block but did not require pacemaker implantation, and other one had mitral regurgitation. A second session was necessary in three patients, two of three accessory pathways were ablated, giving a success rate of 90%. During a one year period of follow-up, we had 4 recurrences (7.2%). Catheter ablation using radiofrequency current is a highly effective and safe curative approach for treating young patients with supraventricular tachycardia mediated by accessory pathways.

Adolescent↗
PubMedDate not supplied

[Radiofrequency ablation of an accessory left lateral pathway in an infant, using a transeptal approach].

We describe the case of a 4 month old child with supraventricular tachycardia detected on his second day of life, refractory to medical treatment, who was treated with radiofrequency catheter ablation of an accessory auriculoventricular pathway located on the left lateral wall. A venous femoral approach was used and the left atrium was entered through a patent foramen ovale, avoiding the risks of the arterial puncture and allowing us to administrate the radiofrequency current on the proper site. We discuss the potential risks of the therapeutic procedure in children and the benefits of the transeptal over the retrograde approaches for the treatment of left sided accessory pathways. Our conclusion is that catheter radiofrequency ablation of accessory pathways in children is possible with low risk, which can be diminished with the use of the transseptal approach when indicated.

Catheter Ablation↗
PubMedDate not supplied

[The implant of a pacemaker cardioverter-defibrillator with a system of endocardial electrodes without thoracotomy].

This article describes the first case in Mexico of an implantable pacer-cardioverter-defibrillator in a 44-year-old man with coronary artery disease and recurrent ventricular tachycardia without the need for a thoracotomy and epicardial electrodes. The patient underwent electrophysiological evaluation that revealed drug-refractory ventricular tachycardia. Endocardial catheter ablation with radiofrequency was considered and rejected due to an unstable hemodynamic state during the tachycardia. A triple electrode system using two transvenous catheter electrodes and a subcutaneous chest patch were employed. Two monophasic unsynchronized shocks were delivered with a 18 J sequential pulse technique over two distinct current pathways. The automatic pacer-cardioverter-defibrillator was implanted in the abdominal wall and demonstrated reproducible termination of ventricular fibrillation.

Adult↗
PubMedDate not supplied

[The radiofrequency ablation of Mahaim and Kent fibers during the repair of Ebstein's anomaly].

A young man 20 years old was referred to the Institute with Ebstein anomaly. He had experienced palpitations since the age of eight. Those episodes occurred several times a year. During the electrophysiologic study a regular antidromic reciprocating tachycardia was induced using a right atriofascicular connection (Mahaim). The atrial insertion of the Mahaim fibers was in the right posterolateral atrium. Also another orthodromic supraventricular tachycardia was induced with anterograde conduction over atrioventricular node and retrograde conduction over to canceled atrioventricular right posteroseptal bypass tract (Kent). During surgery to repair Ebstein anomaly we decided to perform radiofrequency catheter ablation of both Mahaim and Kent fibers at the tricuspid annulus in the posteroseptal and lateral regions, eliminating accessory pathways conduction. There were no complications during the procedure. The tachycardia has not recur in a six months period of follow up. No antiarrhythmic drugs has been given.

Adult↗