Radiofrequency Catheter Ablation of Accessory Pathways: Results of 131 consecutive patients

Patients with supraventricular tachyarrhythmias ınediated by accessory pathways (AP) and refractory to medical therapy are treated effectively by radiofrequency (RF) catheter ablation technique. This safe and effective procedure has replaced the surgical interventions and direct current ablation previously used. Results of radiofrequency catheter ablation procedures in ı3ı consecutive patients with APs were here in reported. · Sixty.seven patients were men and 64 women with the ages ranging ı2 to 66 years (37.ı ± ı2.6). All patients had paroxysmal palpitations resistant to antiarrhythmic drugs which deteriorate their quality of the 13ı patients ll O had orthodromic 5 had antidromic AV reentrant tachycardia, ı2 had orthodromic and antidromic tachycardia, 4 had orthodromic taehyeardİa and atrial fıbrillation, ı had orthodromic tachycardia, antidromic tachycardia and atrial fıbrillation, and ı had only atrial fıbrillation. The AP conduction was manifest (WPW syndrome) in 109 patients (82%) and concealed in 24 patients (18%). There was one AP in ı29 patients and 2 APs in 2 patients. Seventy-three of the AP's (55%) were ıocated at the left free-wall, 48 (36%) were posteroseptal, 7 (5%) were right free-wall and 5 (4%) were midseptal. RF ablation w as successful in ı 14 of 13ı patients (87%) and ı ı6 of ı33 AP's (87%). The procedure was performed in one ses s i on in ı ı O patients and in 2 sessions in the remaining 2ı cases. Mean RF application number was 5 ± 4 (range ı-ı5), mean RF duration was 67 ± 43 second (range ı0-240), mean procedure duration was ı22 ± 56 minutes (range 30-240) and mean fluoroscopy duration was 37 ± 23 minutes (range ı0-90). In 3 patients (2.3%) minor complications occurred. These complications were minimal pericardial effusion, fever lasting for 72 hours and lower extremity thrombophlebitis. The patients were followed for 22.5 ± ı2 months. During this elinical recurrence was observed in 3 patients (2.3%) and successful repeat ablation was performed in one of these patients. The other two patients refused the second procedure. These results confırmed that RF ablation treatment is a safe and effective mode of treatment in patients with drug resisıant supraventricular tachyarrhythmias due to accessory pathways. Increasing experience in this area will lead to higher success rates