Endocardial mapping and radiofrequency catheter ablation of multiple atrioventricular accessory pathways.
Among 174 patients with Wolff-Parkinson-White syndrome, 13 (17.5%) had multiple atrioventricular (AV) accessory pathway. Twenty-one of the 29 pathways were identified by baseline electrophysiologic study and eight were found after the radiofrequency ablation of the initial ones. Bilateral ablation approach was tried in four patients and unilateral approach in nine. Twenty-seven of the pathways (93.1%) were eliminated permanently after a mean of 32 +/- 14 pulses of current delivery. There were no complications. The pulses was more and the procedure took more time (3.6 +/- 0.8 hr) in the group compared to those in single pathway ablation (14 +/- 11 and 2.1 +/- 0.8 hr respectively, P < 0.05). The success rate was identical in the two patient populations (93.1% vs 94.0%, P > 0.05). However, the recurrence in multiple pathway ablation (7.6%) was more than that in single pathway ablation (1.9%, P < 0.01).


CONCLUSIONS
radiofrequency catheter ablation is a safe and effective modality for tachyarrhythmias mediated by multiple accessory pathways.
Wang
L X
LX
Department of Cardiology, First Teaching Hospital of Beijing Medical University.
Ding
Y S
YS
Hu
D Y
DY
D000328:Adult; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*