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Multicenter Study
. 2024 Jul;35(7):1393-1400.
doi: 10.1111/jce.16285. Epub 2024 May 13.

Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia

Juan Sebastian Cabrera  1   2 , Carlos Tapias  1   2 , Christian Adams  1   2 , Boris Hernandez  1   2 , William Bautista  1   2 , Valentina Stozitzky  1 , Alejandro Jimenez Restrepo  3   4 , Luis Saenz  1   2
Affiliations
Multicenter Study

Intracardiac echocardiography guided anatomical ablation of the arcuate ridge for drug refractory inappropriate sinus tachycardia

Juan Sebastian Cabrera et al. J Cardiovasc Electrophysiol. 2024 Jul.

Abstract

Introduction: Inappropriate sinus tachycardia (IST) is a common condition with frequently not tolerated beta-blockers or ivabradine and a high rate of complication in ablation strategy; we describe an alternative anatomical approach of sinus node (SN) modulation.

Methods: This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing SN ablation.

Results: The mean age was 40.6 ± 13.9 years; five of the six patients were female, 100% of patients reported heart palpitations, and 66% reported dizziness, the average heart rate (HR) on a 24-h Holter was 93.2 ± 7.9 bpm. HR during the first stage of a stress test using a standard Bruce protocol was 150 ± 70 bpm, The average HR on 24-h Holter postablation was 75 ± 5.6 bpm, the sinus rate HR during stage 1 of a Bruce protocol exercise stress test was 120 ± 10 bpm.

Conclusion: This is the first case series reporting the acute and long-term results of a novel anatomical approach for SN modulation to treat IST targeting the arcuate ridge (AR) under intracardiac echography (ICE) guidance. The novel anatomic ICE-guided catheter ablation approach aimed to identify the earliest activation at the AR with an extension of RF lesions toward its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.

Keywords: arcuate ridge; catheter ablation; inappropriate sinus tachycardia; intracardiac echography; sinus node.

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References

REFERENCES

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