[Radiofrequency ablation in the treatment of tachyarrhythmias. Experience concerning 1,000 consecutive patients]

Several reports have demonstrated that radiofrequency catheter ablation provides effective control of a variety of tachyarrhythmias. This report details the results of radiofrequency catheter ablation in 1,000 consecutive patients with a wide variety of tachyarrhythmias treated in the Instituto Nacional de Cardiología "Ignacio Chavez". Tachyarrhythmias were associated with the presence of an accessory pathway in 700 patients (70%). Dual accessory pathways were present in 21 patients, giving a total of 722 accessory pathways. The mechanism of the arrhythmia was AV nodal reentrant tachycardia in 204 patients (20.4%). Ablation of the reentrant circuit of atrial flutter within the right atrium was attempted in 56 (5.6%) patients and a primary atrial tachycardia in five patients (0.5%). AV node ablation and permanent pacemaker implantation were performed in 17 patients (1.7%). Finally we performed radiofrequency catheter ablation in 22 (2.2%) patients with ventricular tachycardia. Radiofrequency catheter ablation was successful in 630 of 700 (90%) patients with accessory pathways with a complication rate of 9/700 (1.2%) and a recurrence rate of 73 (12.4%). AV nodal reentry was successfully abolished in 190 of 204 (93%) patients by selective ablation of the slow pathway in 168/180 (93.3%) patients and the fast pathway in 22/24 (92%) patients. The complication rate of this group was 7/204 (3.4%) with a recurrence rate of 30 patients (14.2%). The reentrant circuit of atrial flutter was ablated successfully in 41 of 56 (73%). Four/five (80%) of patients with primary atrial tachycardia were successfully ablated. Complete AV block was achieved in 17/17 patients with atrial fibrillation or flutter treated by AV nodal ablation without complications or recurrence. The procedure was successful in 17/22 (77%) of patients with ventricular tachycardia. The results of this series of patients demonstrate the safety and efficacy of radiofrequency ablation for the treatment of a wide variety of tachyarrhythmias with high rate of success 899/1,000 (89.9%) and with an 1 1.8% of recurrence, low risk of complications (1.5%) and no mortality.