Radiofrequency catheter ablation of accessory pathways. Outcome and use of antiarrhythmic drugs during follow-up.
OBJECTIVE
The purpose of this study was to assess the acute and long-term success of accessory pathway ablation in a single large-volume centre, concentrating on long-term recurrences and the clinical use of antiarrhythmic drugs.


RESULTS
A total of 519 consecutive patients (mean age 40+/-14 years) underwent radiofrequency ablation of manifest or concealed accessory pathways. The patients were seen in the hospital or by the referring physician at 6 and 12 months. Long-term follow-up information was obtained by questionnaire. Pathway conduction was abolished in 476 cases (91.7%). 'Redo' procedures, due to recurrence, were performed in 38 patients (7.3%) and were successful in 30 (78.9%). Follow-up data were obtained from 454 patients (87.5%) with a follow-up duration of 22. 6+/-12.4 months. Among the 398 patients with successful ablations who responded to the questionnaire, 340 (85.4%) were asymptomatic with only 10.6% taking antiarrhythmic drugs. An additional 20 patients (5.0%) had symptoms suspicious of recurrence. In total, 66 out of 398 successfully treated patients (16.6%) were taking antiarrhythmic drugs. Twenty-three out of 56 (41.1%) patients with failed ablations were asymptomatic, 12 of whom (21.4% of patients with failed ablations) had not been administered antiarrhythmic drugs. In the total group of 454 patients with ablation attempts and available follow-up data, 99 (21.8%) were still taking antiarrhythmic drugs during follow-up.


CONCLUSIONS
Patients with successful ablation of accessory pathways show excellent long-term results. However, 17% of successfully treated patients were still taking antiarrhythmic drugs during the period of long-term follow-up. On the other hand, 21% of patients with failed ablations were symptom-free without antiarrhythmic drugs. On an intention-to-treat basis, 22% of the patients with ablation attempts were still taking antiarrhythmic drugs during follow-up.
Dagres
N
N
The Department of Cardiology and Angiology, Hospital of the Westfälische Wilhelms-University and Institute for Arteriosclerosis Research, Münster, Germany.
Clague
J R
JR
Kottkamp
H
H
Hindricks
G
G
Breithardt
G
G
Borggrefe
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001283:Atrioventricular Node / Q000601:surgery*; D017115:Catheter Ablation; D002648:Child; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D011795:Surveys and Questionnaires; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents