Ask Dr. Z

Indications: Syncope and sinus pauses for cardiac ablation. Do you suggest 93656 and 64620 for the destruction of nerves within the autonomic nervous system with radiofrequency or unlisted?

"Fractionated electrograms in the anatomical areas of the ganglionated plexi (superior-anterior to the superior pulmonary veins, anterior ridge between the left pulmonary veins and the appendage and inferior posterior to the inferior pulmonary veins) were tagged for ablation. Radiofrequency current (40 watts) was delivered through the 4 mm-tip electrode catheter using two adhesive conductive pads positioned over the left posterior chest for the return electrode. Multiple RF applications were delivered to the anatomical areas of the ganglionated plexi with some automaticity elicited and rare transient decrease in the sinus CL but no pauses. Additional ablation lesions were delivered to tagged areas in the posterior SVC corresponding to the ablation site in front of the right superior pulmonary vein."