Complications Resulting from Radiofrequency Catheter Ablation in Patients With Supraventricular and Ventricular Tachyarrhythmias by Serial Echocardiographic Examinations

The aim of this study was to evaluate the complications following radiofrequency catheter ablation (RFA) in patients with supraventricular or ventricular tachyarrhythmias. The study material was consisted of 125 (80 males, 45 females; the mean age was 37 .5± 14 years; age range 3.5-69 years) patients. It was applied that 84 ablations of accessory pathway in 75 patients with preexitation syndrome, slow pathway ablation in 21 patients with atrioventricular nodal reentrant tachycardia, focus ablation in 7 patients with ectopic atrial tachycardia, linear ablation in 1 patient with atrial flutter, modification of slow pathway in 1 patient with atrial fibrillation, ablation of His bundle in 3 patients with atrial fibrillo-flutter, and focus ablation - or right bundle ablation- in 17 patients with ventricular tachycardia. The acute anatomic and valvular consequences of radiofrequency ablation were evaluated by means of serial (before and 1, 3, 7 days after the procedure) echocardiographic investigations. Semiquantative assessment of valvular incompetence and classification into one of four grades according to the width and extensions of the jet from the valvular orifice were carried out. Segmental wall motion abnormalities were evaluated semiquantitatively with four grades of severity (normal, hypokinesia, akinesia or dyskinesia). Before the procedure, various echocardiographic abnormalities (mitral valve prolapsus in 16, segmental wall motion abnormality in 7, rheumatic valve disease in 5, dilated cardiomyopathy in 8, hypertrophic cardiomyopathy in 2, arrhythmogenic right ventricular dysplasia in 2, Ebstein abnormality in 1, patent foramen ovale in 3, atrial septal aneurysm in 1, other valvular abnormalities in 5, Eustachian valve in 1 and hypertensive heart disease and left ventricular hypertrophy in 2) were established in 50 (% 40) patients. Subepicardial fat simulating pericardial effusion was observed in 5 patients. New echocardiographic abnormalities were observed in 5 (4 %) patients, medium (<1 cm) pericardial effusion in 2 patients, mild aortic incompetence in 1 patient, increase in severity of tricuspid incompetence in 1 patient and left ventricular thrombus in 1 patient one day after radiofrequency ablation. Segmental wall motion abnormality related to the procedure was not detected. No any other abnormality was detected after the first echocardiographic investigation following ablation. We concluded that these findings confirm the safety of the radiofrequency catheter ablation in the treatment of patients with supraventricular and ventricular tachyarrhythmias, and more than one echocardiographic examination after RFA is unnecessary in all patients.