title: Comparison of direct-current and radiofrequency ablation of free wall accessory atrioventricular pathways in the Wolff-Parkinson-White syndrome.
abstract: To evaluate and compare the safety and efficacy of catheter-mediated direct-current (DC) or radiofrequency (RF) ablation in patients with free wall accessory atrioventricular pathways, 95 patients with free wall accessory atrioventricular pathway-mediated tachyarrhythmias underwent catheter ablation. Immediately after ablation, 27 of 30 accessory pathways (90%) were ablated successfully with DC, but 2 of the 27 had early return of conduction and received a second ablation session; 3 of 8 (38%) and 57 of 62 (92%) accessory pathways were ablated successfully with RF through a small-tip (2 mm) and a large-tip (4 mm) electrode catheter, respectively. Complications in DC ablation included transient hypotension (2 patients) and pulmonary air-trapping (2 patients) and in RF ablation, cardiac tamponade (1 patient) and suspicious aortic dissection (1 patient); myocardial injury and proarrhythmic effects were more severe in DC ablation. Procedure and radiation exposure time were significantly longer in RF ablation (DC, 3.6 +/- 0.2 hours, 34 +/- 4 minutes; RF 4.2 +/- 0.5 hours, 50 +/- 10 minutes). This study confirms that RF ablation is associated with little morbidity and few complications, and RF ablation with a large-tip electrode catheter is an effective and relatively safe nonsurgical method for treatment of free wall accessory atrioventricular pathway-mediated tachyarrhythmias.
authors.affiliation: Department of Medicine, National Yang-Ming Medical College, Taipei, Taiwan, Republic of China.
authors.forename: S A
authors.initials: SA
authors.lastname: Chen
authors.forename: W P
authors.initials: WP
authors.lastname: Tsang
authors.forename: C P
authors.initials: CP
authors.lastname: Hsia
authors.forename: D C
authors.initials: DC
authors.lastname: Wang
authors.forename: C E
authors.initials: CE
authors.lastname: Chiang
authors.forename: H I
authors.initials: HI
authors.lastname: Yeh
authors.forename: J W
authors.initials: JW
authors.lastname: Chen
authors.forename: C W
authors.initials: CW
authors.lastname: Chiou
authors.forename: C T
authors.initials: CT
authors.lastname: Ting
authors.forename: C W
authors.initials: CW
authors.lastname: Kong
mesh_terms: D000328:Adult; D000368:Aged; D004564:Electrocoagulation / Q000009:adverse effects / Q000379:methods*; D006329:Heart Conduction System / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011846:Radio Waves; D014927:Wolff-Parkinson-White Syndrome / Q000601:surgery*