Resumen

ARAYA GOMEZ, Vivien; GUTIERREZ SOTELO, Oswaldo  y  CRUZ CRUZ, Flory. Electrofisiología intervencionista: experiencia inicial en Costa Rica con procedimientos diagnósticos y terapéuticos en arritmias cardíacas. Rev. costarric. cardiol [online]. 2001, vol.3, n.1, pp.22-33. ISSN 1409-4142.

The diagnostic and therapeutic electrophysiology studies are very useful in the clinical practice.The objective of this work is to present the initial experience with interventional electrophysiology in Costa Rica. Between February 1999 and June 2000, we perform 48 procedures. The patients were 25 men (52%) and 23 women (48%). The average age was 50 years (16 to 86 years). The electrophysiology study (EPS) was diagnosticin 14 patients (29%) and therapeutic in 34 (71%). The diagnostic EPS were: Sinus node disfunction: 1 patient, atrioventricular conduction: 2 patients, supraventricular tachycardia: 1 patient, ventricular tachycardia: 10 patients. The therapeutic EPS were: Radiofrequency catheter ablation (RFCA) for paroxismal supraventricular tachycardia (PSVT): 26 patients, RFCA of AV node: 1 patient andcardioverter-defibrillator (ICD) implant: 7 patients. The 26 patients with PSVT had: 14 accessory pathways with both anterograde and retrograde conduction (Wolf-Parkinson-White Syndrome), 6 AV nodal reentrant tachycardias and 8 accessory pathwayswith only retrograde conduction. The RFCA of AV node was perform in one patient who had atrial fibrillation with high ventricular response, refractory to pharmacology treatment.The ICD were implanted in patients with ventricular tachycardia and syncopeand/or ventricular fibrillation. The RFCA was successful in 93% (27/29) with a recurrence rate of 7% (2/27). The follow-up after this procedures was 8 months (range: 15 days to 18months). The were complications in 2 patients (4%): pericardial effusion in one patient and venous thrombosis of right leg in one patient; both were successful resolute. In conclusion, in this patients with sintomatic cardiac arrhythimas is posible a precise diagnostic and definitive treatment with interventional EPS which are effectives and safes in our country. The quality and expectation of life can increase in many of ours patients.

Palabras clave : Therapeutic Electrophysiology; cardiac arrhythimas; Costa Rica.