Effect on Ventricular Performance of Direct Current Electrical Shock for Catheter Ablation of the Atrioventricular Junction

In ten patients undergoing catheter ablation of the atrioventric‐ular junction (CAVJ) because of therapy refractoriness of supraventricular arrhythmias, the effect of repeated high energy direct current (DC) shock on left ventricular function has been investigated. End‐systolic pressure‐volume relat...

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Bibliographic Details
Published in:Pacing and clinical electrophysiology 1992-03, Vol.15 (3), p.344-356
Main Authors: AURICCHIO, ANGELO, KLEIN, HELMUT, TRAPPE, HANS-JOACHIM, SALO, RODNEY
Format: Article
Language:English
Subjects:
Adult
Bundle of His - surgery
Electrocoagulation
Female
Humans
Male
Middle Aged
pressure-volume relation
Prospective Studies
Tachycardia, Supraventricular - epidemiology
Tachycardia, Supraventricular - physiopathology
Tachycardia, Supraventricular - surgery
ventricular function
Ventricular Function, Left - physiology
ventricular relaxation
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Summary:In ten patients undergoing catheter ablation of the atrioventric‐ular junction (CAVJ) because of therapy refractoriness of supraventricular arrhythmias, the effect of repeated high energy direct current (DC) shock on left ventricular function has been investigated. End‐systolic pressure‐volume relation (ESPVR) and the positive first derivative of ventricular pressure (dP/ dt) have been used as indices of left ventricular systolic function, while the time constant of isovolumic pressure decay, the diastolic stiffness, and the negative dP/dt represented the diastolic function parameters, respectively. Each patient received at least two and no more than three DC shocks for successful CAVJ, with an energy of 360 joules. Significant acute reduction of both systolic and diastolic function was noted after each DC shock, with a slow partial recovery of both phases. The recovery process involved the systolic phase earlier and more completely than the diastolic one. The alterations observed could not be predicted from preablation values, but were significantly related to cumulative energy dose index for body weight. In conclusion, repeated high energy DC shocks acutely, but reversibly, impair left ventricular function; in addition, the ventricular function reduction is primarily related to the total ablation energy indexed for body weight.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1992.tb06504.x