Electrical therapeutic procedures in recurrent, drug refractory tachycardias. II. Electrical transvenous catheter ablation

In 6 patients with medicamentously therapy-refractory tachycardias (3 times auricular flutter/auricular fibrillation with very rapid atrioventricular conduction, once focal atrial tachycardia, once paroxysmal atrioventricular reentry tachycardia, once recurrent ventricular tachycardia on the basis of an interventricular reentry) percutaneous transvenous catheter ablations of the atrioventricular conduction region (bundle of His ablation, 5 cases) and the right Tawara branch (1 case), respectively, were performed. During a follow-up period of 2-26 months (on an average 10.5 +/- 8.0 months) a permanent total block in 4 cases could be obtained (3 times AV-block III. once complete right bundle branch block). In two other patients the total AV block receded to the AV block I. and II. respectively, within 2 and 8 days, respectively; in the first case the AV node reentry tachycardias were no more to be evoked, in the second case a tolerable ventricular frequency was the result during the auricular flutter recidivations. In all patients treated by means of catheter ablation after the intervention an impressive improvement of the clinical symptomatology developed. Due to possible complication and the dependence upon the pacemaker of the patients concerned which is to be expected the indication to the ablation should be made only after the exhaustion of all medicamentous possibilities and taking into consideration other electric therapy methods.