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Intracardiac Echocardiography Guided Anatomical Ablation of the Arcuate Ridge for Drug Refractory Inappropriate Sinus Tachycardia
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  • Juan Sebastian Cabrera,
  • Carlos Tapias,
  • Christian D. Adams,
  • Boris Hernandez,
  • William Bautista,
  • Valentina Stozitzky,
  • Alejandro Jimenez Restrepo,
  • Luis Carlos Saenz
Juan Sebastian Cabrera
Fundación Cardioinfantil Electrophysiology department
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Carlos Tapias
Fundación Cardioinfantil Electrophysiology department
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Christian D. Adams
Fundación Cardioinfantil Electrophysiology department
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Boris Hernandez
Fundación Cardioinfantil Electrophysiology department
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William Bautista
Fundación Cardioinfantil Electrophysiology department
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Valentina Stozitzky
Fundación Cardioinfantil Electrophysiology department
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Alejandro Jimenez Restrepo
Florida Electrophysiology Associates
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Luis Carlos Saenz
Fundación Cardioinfantil Electrophysiology department

Corresponding Author:[email protected]

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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 modulation. METHODOLOGY: This retrospective study describes a case series of 6 patients from two centers diagnosed with symptomatic IST undergoing sinus node 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 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-hour Holter post-ablation 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 SNM to treat IST targeting the AR under 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 towards its septal region seems effective and safe to modulate the SN in symptomatic patients with IST refractory to medical treatment.
17 Nov 2023Submitted to Journal of Cardiovascular Electrophysiology
17 Nov 2023Submission Checks Completed
17 Nov 2023Assigned to Editor
17 Nov 2023Review(s) Completed, Editorial Evaluation Pending
19 Nov 2023Reviewer(s) Assigned
05 Mar 20241st Revision Received