[The predictors of success in the radiofrequency ablation of left accessory pathways using the single-catheter technic].
OBJECTIVE
To determine the predictors of successful radiofrequency current ablation of an accessory pathway using the single-catheter approach, we retrospectively analyzed 46 consecutive patients with left sided accessory atrioventricular pathways and manifest preexcitation.


METHODS
Ablation using a single catheter advanced retrogradely towards the mitral valve was successful in 42 (91%). A radiofrequency pulse resulting in permanent accessory pathway block was defined as a successful pulse; a pulse that had no effect or caused only transient accessory pathway block was defined as an unsuccessful pulse.


RESULTS
Successful radiofrequency pulses (n = 37) did not differ from those that failed (n = 56) in the local atrium-accessory pathway potential interval, in the accessory pathway-ventricle interval nor in the cumulative energy delivered. But in successful radiofrequency pulses, the amplitude ratio of local atrium and ventricular potentials tended to be larger (0.29 +/- 0.17 vs 0.23 +/- 0.17; p = 0.053) and presumed accessory pathway potential was more often recorded (36 [97%] vs 38 [68%]; p = 0.006). The time elapsed from the beginning of the current application and the accessory pathway block was shorter in successful pulses as compared to those pulses producing only transient block (3.3 +/- 2 s vs 6.9 +/- 4 s).


CONCLUSIONS
The recording of a presumed accessory pathway potential, a large local A/V ratio and the occurrence of early conduction block in the accessory pathway were the best predictors of successful radiofrequency current application using the single-catheter approach.
Mont
L
L
Departamento de Cardiología, Hospital Universitario Eppendorf, Hamburgo, Alemania.
Schlüter
M
M
Gürsoy
S
S
Siebels
J
J
Kuck
K H
KH
D000293:Adolescent; D000328:Adult; D000368:Aged; D001283:Atrioventricular Node / Q000002:abnormalities / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002648:Child; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011226:Pre-Excitation Syndromes / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies
Predictores de éxito en la ablación de vías accesorias izquierdas mediante radiofrecuencia utilizando la técnica del catéter único.