Long-term results of radiofrequency catheter ablation in patients with multiple accessory pathways.
Information on the long-term results of radiofrequency catheter ablation in a large group of patients with multiple accessory pathways (APs) was not available. This study included 858 patients with Wolff-Parkinson-White syndrome who underwent electrophysiologic study and radiofrequency catheter ablation: 73 patients (8.5%) had multiple APs. Sixty-six patients had 2 APs, 5 had 3 APs, 1 had 4 APs, and 1 had 5 APs. The most common combination pattern of these pathways were concealed APs (38 patients, 52%). Localization of accessory pathways showed a higher incidence of right free wall (22% vs 11%, p < 0.05), anteroseptal, and midseptal APs (9% vs 5%, p < 0.05) in patients with multiple APs than in patients with 1 AP. The most common anatomic sites for multiple APs were 2 APs in the left wall (21 patients, 28%). Although the success rate was similar (98% vs 99%, p > 0.05), procedure time (3.1 +/- 1.2 vs 2.0 +/- 1.1 hours, p < 0.05) and radiation exposure time (48 +/- 26 vs 29 +/- 19 minutes, p < 0.05) were longer in patients with multiple APs. The recurrence rate was higher in patients with multiple APs (9.5% vs 2.5%, p < 0.05), and the most common site of recurrent APs was in the left free wall (7.2%); in contrast, it was in the right free wall in patients with 1 AP. These findings demonstrated that a high success rate of radiofrequency catheter ablation was found in patients with multiple APs; however, the higher recurrence rate in patients with multiple APs should be considered.
Huang
J L
JL
Department of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
Chen
S A
SA
Tai
C T
CT
Chiang
C E
CE
Lee
S H
SH
Chiou
C W
CW
Ueng
K C
KC
Wen
Z C
ZC
Yu
W C
WC
Chen
Y J
YJ
Chang
M S
MS
D000328:Adult; D017115:Catheter Ablation; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology / Q000601:surgery*