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At least 19 recordsLinked to original sources
PubMed1993

Should radiofrequency therapy be performed in every symptomatic patient with supraventricular tachycardia? (Pro drug position).

The indication for treatment of paroxysmal supraventricular tachycardia depends on the frequency and severity of the tachycardia attacks. If the tachycardia attacks are mildly symptomatic and occur only once or twice a year, there is no indication for either continuous drug therapy or radiofrequency ablation. The only therapeutic measure required is termination of each acute event. If symptoms occur frequently, long-term antiarrhythmic drug therapy is then indicated and will be effective for chronic prophylaxis in most individuals with a low risk of proarrhythmic events. Only in patients with severe or life-threatening symptoms or cases refractory to drug therapy would radiofrequency ablation possibly be justified.

Anti-Arrhythmia Agents↗
PubMed1996

Interstitial radiofrequency therapy of the prostate: results of a pilot study.

PURPOSE: We assessed the feasibility of using interstitial radiofrequency therapy for benign prostatic hyperplasia (BPH) in 50 patients. MATERIALS AND METHODS: Therapy was given using a standard diathermy unit as the radiofrequency generator and a disposable needle electrode. The main outcome measure was improvement in symptoms assessed by symptom scores. RESULTS: Patients with bothersome symptoms or acute retention showed clinically significant improvements in symptom score, while those with chronic retention did not. There were no serious complications. CONCLUSIONS: Interstitial radiofrequency therapy may be effective for symptomatic BPH. Further studies with long-term objective data are under way to assess its role in the management of BPH.

Aged↗
PubMed1976

Tumor eradication by radiofrequency therapy. Responses in 21 patients.

Tumor blood flow, measured by an isotope dilution technique, is only 2% to 15% of that of the surrounding tissue. This sluggish circulation differentiates cancer from normal tissue and forms the basis for a new therapy that entails the transfer of radiofrequency (RF) energy for heating tissues locally. The heated tissue is cooled by the circulation of blood, which carries away the heat. Impaired perfusion, as in cancers, impedes cooling. Heating by RF elevated the temperatures of animal and human cancers by 5 to 9.5 C above that of healthy tissue. The heat eradicated the animal cancers without destruction of normal tissue. Radiofrequency therapy produced tissue necrosis or substantial regression of cancer in 21 patients.

Animals↗
PubMed1997

A prospective randomized trial of interstitial radiofrequency therapy versus transurethral resection for the treatment of benign prostatic hyperplasia.

OBJECTIVE: To carry out a prospective randomized trial comparing interstitial radiofrequency therapy (IRFT) with transurethral resection of the prostate (TURP) in the treatment of bladder outlet obstruction (BOO) caused by benign prostatic hyperplasia. PATIENTS AND METHODS: The change in detrusor pressure at maximum flow (PdetQmax) was chosen as the primary measure of outcome but the symptom score, Qmax and residual volume were also measured. Patients with urodynamic evidence of BOO were randomized to receive IRFT (n = 25) or TURP (n = 25); the urodynamics were repeated 6 months after treatment. RESULTS: There was a statistically significant reduction in PdetQmax at 6 months for TURP (P < 0.001) and IRFT (P < 0.01) although the change seen in the latter group was probably not clinically relevant. Nevertheless, a clinically relevant reduction in symptom score occurred in both groups. Both techniques were associated with a low morbidity. CONCLUSION: IRFT is a cheap and safe technique which may be useful in the treatment of lower urinary tract symptoms in certain groups of patients in whom symptomatic improvement is a priority rather than objective outcome. The underlying mechanism for this symptomatic improvement is at present unclear.

Aged↗
PubMed1998

Interstitial radiofrequency therapy of the prostate in the management of acute urinary retention.

OBJECTIVE: To evaluate in a prospective study the efficacy of interstitial radiofrequency therapy (IRFT) of the prostate in relieving acute urinary retention in patients with benign prostatic hyperplasia. PATIENTS AND METHODS: Twenty-seven patients presenting in acute urinary retention who failed at least one trial of voiding one week after presentation were treated with IRFT of the prostate. During the 6-month follow-up, the International Prostate Symptom Score (IPSS), urinary flow rate, post-void residual volume (PVR) and serum creatinine were determined and changes in erectile and ejaculatory functions recorded. The treatment was considered successful if the patient resumed normal voiding, without compromising renal function and without troublesome lower urinary tract symptoms necessitating further treatment. RESULTS: Of the 26 evaluable patients, 77% resumed normal voiding. At 6 months after treatment, the mean (SD) IPSS had decreased from 15.0 (8.3) to 8 (5.4), the PVR from 950 (203) to 88 (60) mL and the maximum flow rate was 10.5 (4.36) mL/s. CONCLUSION: IRFT of the prostate is a safe and effective treatment, at least in the short-term, for relieving acute urinary retention in patients with benign prostatic hyperplasia. The longer term follow-up is continuing.

Acute Disease↗
PubMed1982

Radiofrequency hyperthermia for clinical cancer therapy.

Radiofrequency heating by the inductive or capacitive mode has the potential to induce hyperthermia at depth. Progress with the capacitive heating with the use of multiportal electrodes and impedance matching showed promise for improved depth of heating. However, heating of the fatty tissue remains a major obstacle. The inductive modality has been widely used for diathermy, and a modified unit is being used for treatment of superficial tumors. The inductive mode has great promise for heating deep-seated tumors because it is least affected by the tissue inhomogeneities. With radiofrequency heating, temperature measurements between the tumor and the adjacent normal tissue almost always showed a selective heating pattern. Tumor response to the heat alone has been transitory; however, permanent control can be achieved in over 75% when combined with irradiation without an increase in normal tissue complications.

Body Temperature↗
PubMed1994

[Percutaneous radiofrequency coagulation therapy for liver tumor: experimental study].

We invented a newly devised local thermal therapy using radiofrequency energy for treating liver tumors. This method was investigated for evaluating its safety and effectiveness. In vitro study, the maximum size of coagulated albumen was 5.5 to 6.2mm in diameter, and 9.8 to 11.3mm in length. In vivo study using rabbit's liver, the range of coagulated tissue by radiofrequency energy was localized around the tip of the needle. Percutaneous radiofrequency coagulation therapy will be the effective therapy for liver tumor regardless of tumor vascularity.

Animals↗
PubMedDate not supplied

Combined therapy with radiofrequency thermal ablation and intra-arterial infusion chemotherapy for hepatic metastases from colorectal cancer.

BACKGROUND/AIMS: In this preliminary study, we investigated the efficacy of combined radiofrequency thermal ablation therapy (RFA) with hepatic arterial infusion chemotherapy (HAI) in the treatment of multiple liver metastases from colorectal cancer. METHODOLOGY: Nine patients with bilobular multiple metastases was treated. The number of nodules was 6.0 +/- 3.9 (range: 2-13), and the size was 2.1 +/- 1.0 cm (range: 0.5-4.8 cm) in diameter. RFA was performed using a RF generator operating at 460 kHz with a 15-gauge, 4-prong custom RF needle. Treatment temperature was kept at 90-110 degrees C for 5 min. 5-Fluorouracil (5-FU) was administered by weekly 750-1250 mg/body/5 h as the regimen of HAI. RESULTS: During a 15.2-month follow-up period, 6 of 9 patients survived more than 1 year. Three of the 6 survived more than 2 years. Serum CEA level in 5 patients dropped from 24.5 +/- 9.5 ng/ml to 10.3 +/- 5.5 ng/ml. Local recurrence was observed in 5 patients and new lesions in 4. Extrahepatic recurrence was observed in 5 patients. There were no serious complications but one HAI-related cerebral thrombosis. CONCLUSIONS: Combined RFA with HAI would be effective and safe. This modality provides a new option for the treatment of multiple liver metastases from colorectal cancer.

Adult↗
PubMed1999

Transurethral needle ablation (TUNA). A critical review of radiofrequency thermal therapy in the management of benign prostatic hyperplasia.

Radiofrequency thermal therapy of the prostate is a new minimally invasive treatment for symptomatic benign prostatic hyperplasia (BPH). The procedure is called transurethral needle ablation (TUNA). With TUNA, the inner region of the prostate is selectively ablated with temperatures approaching 90-100 degrees C while the prostatic urothelium is preserved. The objective of this article is to discuss the basics of radiofrequency energy, instrumentation, surgical techniques, and to present an update of the clinical results as it applies to the treatment of BPH.

Animals↗
PubMed1993

Radiofrequency ablation therapy in three patients with paroxysmal atrial tachycardia.

Radiofrequency ablation therapy was performed in three patients with paroxysmal atrial tachycardia. There were two females and one male, aged 80, 63, and 75 years, respectively. All three patients had induction of sustained atrial tachycardia. The tachycardia could be terminated by overdrive atrial pacing or atrial premature stimulation; it could also be terminated by intravenous bolus of adenosine triphosphate. In all three patients, there was no fragmented atrial electrograms recorded within the right atrium, and there was no ventriculo-atrial conduction during ventricular pacing. The earliest atrial activation during tachycardia in these three patients was registered, respectively, at a site slightly posterior and inferior to the His-bundle recording site, at the anterior-superior border of Koch's triangle slightly posterior to the His-bundle recording site, and at the mid-lateral aspect of the right atrium over the crista terminalis at the junction of right atrial appendage and sinus venarum. Radiofrequency current was delivered to the site of the earliest atrial activation during tachycardia through a 4-mm tip electrode catheter. It resulted in termination of tachycardia and ablation of the tachycardia focus. Follow-up observation over a period of 16, 15, and 4 months, respectively, in these three patients showed no recurrence of tachycardia. A repeat electrophysiological study was performed 52 and 63 days after ablation in two patients and revealed no induction of atrial tachycardia.

Aged↗
PubMed1994

Radiofrequency ablation therapy in idiopathic left ventricular tachycardia with no obvious structural heart disease.

BACKGROUND: The feasibility and efficacy of radiofrequency ablation therapy in idiopathic left ventricular tachycardia has not been assessed in a large group of patients. METHODS AND RESULTS: Twenty consecutive patients with idiopathic left ventricular tachycardia and without structural heart disease underwent electrophysiological study, pharmacological interventions with administration of verapamil and adenosine, and radiofrequency ablation therapy. There were 17 men and 3 women with a mean age of 28 +/- 8 years. The QRS configuration during tachycardia was of right bundle branch block and superior axis in 13 patients, indeterminate axis in 6 patients, and right axis in 1 patient. The tachycardia was electrically inducible and responsive to verapamil but not to adenosine. Thirteen patients demonstrated entrainment. Activation and pace-mapping studies disclosed that the tachycardia originated from the inferior apical septum in 15 patients, the midseptum in 4 patients, and the anterior lateral wall of the left ventricle in 1 patient. Radiofrequency ablation was successful in 17 of the 20 patients (85%). The successful ablation sites were characterized by an endocardial activation time 30 milliseconds earlier than the onset of QRS during tachycardia and by a pace-mapping QRS similar to or closely resembling the tachycardia. All patients displayed sharp spikes preceding the local ventricular electrogram at the ablation site. However, these sharp spikes also were noted in 15 control patients and were not specific for this tachycardia; they persisted after ablation. There were no complications. A follow-up of 7 +/- 8 months in the 17 successfully ablated patients showed no symptomatic tachyarrhythmias without medications. Six patients underwent repeat electrophysiological study, and no induction of tachycardia was revealed. CONCLUSIONS: Radiofrequency ablation therapy is effective and safe in patients with idiopathic left ventricular tachycardia. It should be considered as the primary therapeutic modality in these patients.

Adult↗
PubMed1995

Radiofrequency ablation therapy in concealed left free wall accessory pathway with decremental conduction.

An electrophysiologic study followed by transcatheter radiofrequency ablation therapy was performed in two adult patients with a permanent form of junctional tachycardia. Both patients had no structural heart disease and exhibited a normal resting ECG. The P wave during tachycardia was negative in leads 1, 3, and aVF, biphasic over V6, and positive in V1 and aVL in both patients, while the P-R/R-P interval ratio during tachycardia was 0.82 and 0.36, respectively, in both patients. Both patients displayed an eccentric atrial activation sequence with the earliest atrial activation occurring at the distal coronary sinus and a decremental retrograde conduction property during incremental ventricular pacing, suggesting the presence of a concealed slowly conducting left free wall accessory pathway. The tachycardia used the normal atrioventricular pathway for anterograde conduction and the concealed show left accessory pathway for retrograde conduction. It was terminated following adenosine administration in both patients; termination of tachycardia was due to a block in the retrograde accessory pathway in one patient and due to a block in the atrioventricular node in the other patient. Radiofrequency ablation was performed by the retrograde transaortic approach. The radiofrequency f4p4ent was delivered to the site of the earliest atrial activation during tachycardia at the ventricular aspect of the mitral annulus. The successful ablation site had a ventriculoatrial (VA) interval of 120 and 130 ms, respectively, and was located at the posterolateral and lateral aspects of the mitral annulus. Following ablation, there was no VA conduction; however, conduction through the normal atrioventricular pathway was noted during isoproterenol infusion in both patients. There was no induction of tachycardia. This study demonstrates that the permanent form of junctional tachycardia in adults can incorporate a concealed left free wall accessory pathway with a decremental property. Radiofrequency ablation therapy is effective and safe in this form of arrhythmia.

Adult↗
PubMed1994

Radiofrequency ablation therapy in atypical or multiple atrioventricular node reentry tachycardias.

Electrophysiologic study and radiofrequency ablation therapy were performed in 23 patients with atypical (8 patients) or multiple (15) atrioventricular node reentry tachycardias. Dual pathways with anterograde fast and slow pathway conductions were demonstrated in 16 patients. Studies on retrograde conduction revealed the presence of three different pathways, including fast (15 patients), intermediate (17), and slow (16). The radiofrequency current was applied to the inferior aspect, one-third anterior two-thirds posterior between the His bundle and the ostium of the coronary sinus, of Koch's triangle along the tricuspid annulus in all patients. Application of the current resulted in selective ablation or modification of both retrograde intermediate and slow pathway conductions in 20 patients. In two patients retrograde fast pathway conduction was also modified. Complete atrioventricular block occurred in the remaining patient. Sixteen patients had no induction of tachycardia or echo, 4 had induction of a single echo, and 2 had induction of the slow-fast form tachycardia; one of those 2 patients underwent a second trial and was successful. A median application of 2 was delivered at a power of 25 +/- 5 W and a duration of 18 +/- 4 sec. The total fluoroscopic time was 25 +/- 21 minutes. The anterograde fast pathway conduction was unaffected; the shortest atrial paced cycle length that sustained 1:1 fast pathway conduction was 329 +/- 65 msec and 330 +/- 68 msec before and after ablation, respectively. A follow-up electrophysiologic study was performed in 16 patients 60 +/- 15 days after ablation. Eleven had no induction of tachycardia or echo, and five had induction of < 3 echoes. This study demonstrated that radiofrequency ablation with the inferior approach is effective and safe in atypical or multiple atrioventricular node reentry tachycardias. It resulted in ablation of the slow pathway and retrograde intermediate pathway conduction with preserved atrioventricular conduction.

Adult↗
PubMed1994

Characteristics and radiofrequency ablation therapy of intermediate septal accessory pathway.

Fourteen patients (5%) with an intermediate septal accessory pathway were identified among 283 consecutive patients with the Wolff-Parkinson-White syndrome who had electrophysiologic study and radiofrequency ablation therapy. Nine were women and 5 were men (mean age 33 +/- 13 years). The resting electrocardiogram showed ventricular preexcitation in 8 patients and normal PR interval in 6. Anterograde and retrograde mapping studies revealed that the accessory pathway was para-Hisian in 11 patients and paranodal in 3. The accessory pathway was successfully ablated in 10 patients (9 para-Hisian and 1 paranodal) and damaged in 1 (para-Hisian). Treatment of 3 patients was complicated by transient atrioventricular (AV) block, of 1 by intermittent second-degree AV block, and of another by permanent complete AV block requiring implantation of a permanent pacemaker. Six patients underwent a follow-up electrophysiologic study 84 +/- 55 days after ablation; none had induction of tachycardia even after isoproterenol infusion. It is concluded that radiofrequency ablation therapy for intermediate septal accessory pathway is feasible. However, the success rate is only modest (71%), whereas complications with heart block (36%) or complete right bundle branch block (29%) are high. Thus, the procedure should be reserved for patients with life-threatening or troublesome symptomatic tachyarrhythmias.

Adolescent↗
PubMed1994

Late clinical and electrophysiologic outcome of radiofrequency ablation therapy by the inferior approach in atrioventricular node reentry tachycardia.

A late electrophysiologic study was conducted in 182 of 289 patients with slow-fast atrioventricular node reentry tachycardia 81 +/- 36 days after radiofrequency ablation therapy by the inferior approach. Of these 182 patients, electrophysiologic study immediately after ablation revealed a selective modification of the slow pathway in 159, a modification of both the slow and fast pathways in 15, a modification of the fast pathway alone in 3, and failure of ablation in 5. One hundred two patients had no induction of echoes; 75 had induction of fewer than four echoes; and 5 had induction of sustained tachycardia with or without isoproterenol infusion. The late electrophysiologic study in these 182 patients revealed a persistent effect without changes in conduction properties in 161 (88%) patients. A change in conduction properties was noted in 21 patients, including 5 with resumption of slow- or fast-pathway conduction with induction of sustained tachycardia, 8 with improved fast- or slow-pathway conduction, and 8 with an additional depression of fast- or slow-pathway conduction. Of the 102 patients with no induction of echoes and the 75 patients with induction of fewer than four echoes during the immediate postablation electrophysiologic study, 5 (3 and 2, respectively) patients had induction of tachycardia. Of the 5 patients with induction of sustained tachycardia in the immediate postablation electrophysiologic study, 3 continued to have induction of sustained tachycardia; 1 had induction of echoes only; and 1 had no induction of echoes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1996

Radiofrequency ablation therapy of the posteroseptal accessory pathway.

Among 652 patients with Wolff-Parkinson-White syndrome who underwent radiofrequency ablation in this laboratory, 139 (21%) were found to have a total of 146 posteroseptal accessory pathways. Ablation was conducted by the regular transvenous or transaortic approach; ablation from cardiac venous structures was used only if regular approaches were unsuccessful. Of the 146 posteroseptal accessory pathways, 94 were successfully ablated from the left posteroseptal region and 45 from the right posteroseptal region. In 3, successful ablation of the accessory pathway required delivery of the current to the proximal coronary sinus, and in 1 it required delivery of the current to both the atrial and ventricular aspects of the tricuspid valve at the right posteroseptum. Thus, the accessory pathway was successfully ablated in 143 (98%) of 146 instances or in 136 (98%) patients. In 3 patients, ablation was unsuccessful despite delivery of current to the left posteroseptum, the right posteroseptum, the proximal coronary sinus, and the middle cardiac vein. Seventy-seven (57%) patients with an initial success, including 9 patients with resumed preexcitation or recurrence of paipitations, underwent a follow-up electro-physiologic study 90 +/- 72 days after ablation. Of these 9 patients, the initial successful ablation site was the right posteroseptum in 7 and the left posteroseptum in 2. The accessory pathways were ablated successfully by subsequent trials in 8 patients, whereas in 1 the accessory pathway was severely damaged. Thus radiofrequency ablation of posteroseptal accessory pathways can be achieved by the regular transvenous or transaortic approach; delivery of current to the coronary sinus or middle cardiac vein is unnecessary in most patients.

Adult↗
PubMed1997

Mechanisms and medical management of patients with atrial flutter.

Type I atrial flutter is due to reentrant excitation, principally in the right atrium. The standard ECG remains the cornerstone for its clinical diagnosis. Acute treatment should be directed at control of the ventricular response rate and, if possible, restoration of sinus rhythm. Radiofrequency catheter ablation therapy provides the best hope of cure, although atrial fibrillation may subsequently occur after an ostensibly successful ablative procedure. Alternatively, antiarrhythmic drug therapy to suppress recurrent atrial flutter episodes may be useful, recognizing that occasional recurrences are common despite therapy. Radiofrequency ablation of the His bundle ablation with placement of an appropriate pacemaker system may be useful in selected patients.

Animals↗