Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome.
OBJECTIVE
To report on the experience with radiofrequency catheter ablation of accessory atrioventricular pathways in patients with Wolff-Parkinson-White syndrome in terms of the duration of fluoroscopy exposure to the patient and the operator and the effect of accessory-pathway location and operator experience on the success rate.


METHODS
Retrospective review.


METHODS
Tertiary care university hospital.


METHODS
Two hundred consecutive patients with Wolff-Parkinson-White syndrome who underwent radiofrequency catheter ablation between September 1990 and June 1992.


METHODS
Electrophysiologic study and radiofrequency catheter ablation.


METHODS
Success rate, duration of fluoroscopy, complications and long-term follow-up.


RESULTS
Of the 224 accessory pathways in the 200 patients 135 were left free wall, 47 posteroseptal, 32 right free wall and 10 anteroseptal. The overall success rate increased from 53% in the first 3 months of the study period to 96% in the last 3 months. The success rate depended on the location of the accessory pathway. The duration of fluoroscopic exposure decreased from 50 (standard deviation [SD] 21) minutes in the first 3 months to 40 (SD 15) minutes in the last 3 months (p < 0.05). Complications occurred in 3.5% of the patients; they included hemopericardium, cerebral embolism, perforation of the right atrial wall, air embolism in a coronary artery and hematoma at the arterial perforation site. None of the complications resulted in death.


CONCLUSIONS
With experience, radiofrequency catheter ablation of accessory pathways can have an overall success rate of more than 95% and a complication rate of less than 4%. Such rates make this procedure suitable for first-line therapy for patients with Wolff-Parkinson-White syndrome.
Thakur
R K
RK
Department of Medicine, University of Western Ontario, London.
Klein
G J
GJ
Yee
R
R
D000293:Adolescent; D000328:Adult; D001283:Atrioventricular Node / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D002648:Child; D004562:Electrocardiography; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006325:Heart Atria / Q000293:injuries; D006346:Heart Septum / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000209:etiology; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology; D011829:Radiation Dosage; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*