Does Radiofrequency Catheter Ablation Induce a Deterioration in Sympathetic Innervation? A Positron Emission Tomography Study

Radiofrequency catheter ablation (RFCA) is an effective treatment for the interruption of accessory bypass tracts in WPW syndrome or the modification of the Ay‐nodal conduction system in patients with A V‐nodal tachycardias. However RFCA may also damage cardiac innervation. The purpose of this pilot...

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Published in:Pacing and clinical electrophysiology 1998-01, Vol.21 (1), p.327-330
Main Authors: SCHMITT, CLAUS, MEYER, CHRISTIAN, KOSA, ISTVAN, WEYERBROCK, SONJA, SCHNEIDER, MICHAEL, ZRENNER, BERNHARD, PLEWAN, ANDREAS, SCHÖMIG, ALBERT, SCHWAIGER, MARKUS
Format: Article
Language:English
Subjects:
Adult
Ammonia
Carbon Radioisotopes
cardiac innervation
Catheter Ablation - adverse effects
Contrast Media
Ephedrine - analogs & derivatives
Female
Heart - diagnostic imaging
Heart - innervation
Humans
Male
Nitrogen Radioisotopes
Pilot Projects
positron emission tomography
radiofrequency catheter ablation
Sympathetic Nervous System - injuries
Tachycardia, Supraventricular - diagnostic imaging
Tachycardia, Supraventricular - surgery
Tomography, Emission-Computed
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Summary:Radiofrequency catheter ablation (RFCA) is an effective treatment for the interruption of accessory bypass tracts in WPW syndrome or the modification of the Ay‐nodal conduction system in patients with A V‐nodal tachycardias. However RFCA may also damage cardiac innervation. The purpose of this pilot study was to assess possible changes in sympathetic innervation after RFCA as evaluated by the cathecholamine analog carbons‐11‐ hydoxyephedrine (HED) positron emission tomography (PET) which allows the visualisation of sympathetic nerve terminals. We investigated nine patients with supraventricular tachycardias before and two to six weeks after RFCA. Myocardial perfusion was depicted by n‐I3‐ammonia‐PET. In addition to visual analysis, HED retention was quantified in the myocardial quadrant distal to the location of intervention; these results were compared with values in remote areas. Before RFC A, myocardial perfusion showed homogenous distribution in 8 of 9 patients. One patient showed a perfusion defect in the posterior wall. HED retention matched perfusion distribution in all patients. After RF'CA there was no significant change observed either in ammonia or in HED distribution. Quantitative HED retention data showed no significant change before versus after RFC A. Thus, HED‐PET does not demonstrate any abnormalities of tracer uptake indicating integrity of sympathetic nerve terminals after radiofrequency ablation therapy.
ISSN:0147-8389
1540-8159
DOI:10.1111/j.1540-8159.1998.tb01115.x