title: Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction: final results of a prospective, multicenter clinical trial. The Atakr Multicenter Investigators Group.
abstract: BACKGROUND
  The purpose of this study was to evaluate the safety and efficacy of a temperature-controlled radiofrequency catheter ablation system.
  
  
  RESULTS
  The patient population included 1050 patients who had undergone ablation of atrioventricular nodal reentrant tachycardia (AVNRT), an accessory pathway (AP), or the atrioventricular junction (AVJ). Ablation was successful in 996 patients. The probability of success was highest among patients who had undergone ablation of the AVJ, lowest in patients who had undergone ablation of an AP, and in between for patients who had undergone ablation of AVNRT. A major complication occurred in 32 patients. Four variables predicted ablation success (AVJ, AVNRT, or left free wall AP ablation and an experienced center). Four factors predicted arrhythmia recurrence (right free wall, posteroseptal, septal, and multiple APs). Two variables predicted development of a complication (structural heart disease and the presence of multiple targets), and 3 variables predicted an increased risk of death (heart disease, lower ejection fraction, and AVJ ablation).
  
  
  CONCLUSIONS
  These findings may serve as a guide to clinicians considering therapeutic options in patients who are candidates for ablation.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA. hcalkins@welchlink.welch.jhu.edu
authors.forename: H
authors.initials: H
authors.lastname: Calkins
authors.forename: P
authors.initials: P
authors.lastname: Yong
authors.forename: J M
authors.initials: JM
authors.lastname: Miller
authors.forename: B
authors.initials: B
authors.lastname: Olshansky
authors.forename: M
authors.initials: M
authors.lastname: Carlson
authors.forename: J P
authors.initials: JP
authors.lastname: Saul
authors.forename: S K
authors.initials: SK
authors.lastname: Huang
authors.forename: L B
authors.initials: LB
authors.lastname: Liem
authors.forename: L S
authors.initials: LS
authors.lastname: Klein
authors.forename: S A
authors.initials: SA
authors.lastname: Moser
authors.forename: D A
authors.initials: DA
authors.lastname: Bloch
authors.forename: P
authors.initials: P
authors.lastname: Gillette
authors.forename: E
authors.initials: E
authors.lastname: Prystowsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000209:etiology; D001283:Atrioventricular Node / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006329:Heart Conduction System / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012449:Safety; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000601:surgery*; D016896:Treatment Outcome