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Outpatient radiofrequency catheter ablation

Ambulante Hochfrequenzenergie-Katheterablation

  • Outpatient Coronary Angiography and Interventions
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Summary

Outpatient radiofrequency catheter ablation has been shown to be safe and cost effective in the treatment of supraventricular tachycardias due to atrioventricular nodal reentrant tachycardia and atrioventricular reentry tachycardia. Complications secondary to vascular access are similar to those during outpatient cardiac catheterization procedures. Specific complications due to catheter manipulation and radiofrequency ablation include among others cardiac tamponade, AV block and proarrhythmia. Proper patient selection can help to prevent specific complications in outpatient ablations. Patients probably not suitable for outpatient procedures include the elderly as well as comorbid patients. Not all ablation procedures are suitable for the outpatient setting. Ablation procedures with an increased risk of AV block or proarrhythmia should not be performed on an outpatient basis. In order to effectively perform outpatient procedures a back up support with specially trained personnel is helpful. Radiofrequency ablations require considerable experience, therefore ablation procedures in the outpatient setting should be restricted to operators with adequate experience.

Zusammenfassung

Für die ambulante Katheterablation supraventrikulärer Tachykardien mit Hochfrequenzenergie konnte gezeigt werden, daß die Eingriffe bei der AV-Knote-Reentry-Tachykardie sowie bei der AV-Reentry-Tachykardie mit einem hohen Maß an Sicherheit und Kosteneffizienz durchgeführt werden können. Komplikationen, die im Rahmen des vaskulären Zugangs entstehen, entsprechen zum großen Teil denen der ambulanten Herzkatheteruntersuchung. Spezielle Komplikationen, die bei der Kathetermanipulation und der Ablation mit Hochfrequenzenergie entstehen können, beinhalten Perikardtamponade, AV-Blockierung sowie proarrhythmische Ereignisse. Mit Hilfe einer konsequent durchgeführten Patientenselektion können diese Komplikationen bei ambulanten Eingriffen größtenteils verhindert werden. Ältere sowie komorbide Patienten sind für eine ambulante Katheterablation nicht geeignet. Auf der anderen Seite sollte auch eine Selektion hinsichtlich der zu behandelnden Rhythmusstörung erfolgen. Eingriffe mit erhöhtem Risiko für AV-Blockierung oder Proarrhythmier sollten lediglich unter stationären Bedingungen durchgeführt werden. Um eine effektive und sichere Katheterablation von Rhythmusstörungen unter ambulanten Bedingungen zu gewährleisten, ist eine Überwachungseinheit mit speziell trainiertem Personal notwendig. Katheterablationen erfordern ein hohes Maß an Erfahrung. Daher sollten ambulante Ablationen lediglich von Untersuchern mit entsprechender Erfabrung durchgeführt werden.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiology, University of Michigan Medical Center, Ann Arbor, Michigan, USA

    F. Bogun M.D.

  2. Abteilung für Innere Medizin IV, Medizinische Universitätsklinik Theodor-Stern-Kai 7, D-60590, Frankfurt, Germany

    F. Bogun M.D. & F. Morady

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  1. F. Bogun M.D.
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  2. F. Morady
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Correspondence to F. Bogun M.D..

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Bogun, F., Morady, F. Outpatient radiofrequency catheter ablation. Herz 23, 42–46 (1998). https://doi.org/10.1007/BF03043011

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  • DOI: https://doi.org/10.1007/BF03043011

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