title: Long-term results of radiofrequency catheter ablation in patients with multiple accessory pathways.
abstract: 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.
authors.affiliation: Department of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
authors.forename: J L
authors.initials: JL
authors.lastname: Huang
authors.forename: S A
authors.initials: SA
authors.lastname: Chen
authors.forename: C T
authors.initials: CT
authors.lastname: Tai
authors.forename: C E
authors.initials: CE
authors.lastname: Chiang
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: C W
authors.initials: CW
authors.lastname: Chiou
authors.forename: K C
authors.initials: KC
authors.lastname: Ueng
authors.forename: Z C
authors.initials: ZC
authors.lastname: Wen
authors.forename: W C
authors.initials: WC
authors.lastname: Yu
authors.forename: Y J
authors.initials: YJ
authors.lastname: Chen
authors.forename: M S
authors.initials: MS
authors.lastname: Chang
mesh_terms: 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*