A. Proclemer et al., Safety of pacemaker implantation prior to radiofrequency ablation of atrioventricular junction in a single session procedure, PACE, 23(6), 2000, pp. 998-1002
Citations number
15
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
RF current delivery may cause acute and chronic dysfunction of previously i
mplanted pacemakers. The aim of this study was to assess prospectively the
effects of RF energy on Thera I and Kappa pacemakers in 70 consecutive pati
ents (mean age 70 +/- 11 years, mean left ventricular ejection fraction 48
+/- 15%) who underwent RF ablation of the AV junction for antiarrhythmic dr
ug refractory atrial fibrillation (permanent in 42 patients, paroxysmal in
28). These pacing systems incorporate protection elements to avoid electrom
agnetic interference. The pacemakers (Thera DR 7960 I in 20 patients, Thera
SR 8960 I in 30, Kappa DR 600-601 in 8, Kappa SR 700-701 in 12) were impla
nted prior to RF ablation in a single session procedure and at ere transien
tly programmed to VVI mode at a rate of 30 beats/min. Capsure SP and Z unib
ipolar leads were used. During RF application there was continuous monitori
ng of three ECG leads, endocavitary electrograms, and event markers. Comple
te AV block was achieved in all cases after 3.6 +/- 2.9 RF pulses and 100 /- 75 seconds of RF energy delivery. The mean lime of pacemaker implantatio
n and RF ablation was 60 +/- 20 minutes. Transient or permanent pacemaker d
ysfunction including under/oversensing, reversion to a "noise-mode" pacing,
pacing inhibition, reprogramming, or recycling were not observed. Leads im
pedance, sensing, and pacing thresholds remained in the normal range in the
acute and long-term phase (average follow-up 18 +/- 12 months). In conclus
ion, Thera I and Kappa pacemakers exhibit excellent protection against inte
rference produced by RF current. The functional integrity of the pacemakers
and Capsure leads was observed in the acute and chronic phases. Thus, the
implantation of these pacing systems prior to RF ablation of the AV junctio
n can be recommended.