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Late clinical outcome after successful radiofrequency catheter ablation of accessory pathways
1Division of Cardiology, University Hospital, Lausanne, Switzerland.
Insights
Radiofrequency catheter ablation for accessory pathway tachycardia shows a low 4% long-term recurrence rate. Most patients remain symptom-free long after the procedure for drug-resistant tachycardia.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Accessory pathway-mediated tachycardia is a common cause of symptomatic arrhythmias.
- Drug-resistant cases often require invasive treatment like radiofrequency catheter ablation.
Purpose of the Study:
- To evaluate the long-term clinical outcomes of radiofrequency catheter ablation for symptomatic accessory pathway-mediated tachycardia.
- To determine the recurrence rate and causes of symptoms post-ablation.
Main Methods:
- A cohort of 180 patients with drug-resistant accessory pathway tachycardia underwent successful radiofrequency catheter ablation.
- Clinical follow-up was conducted via direct contact with patients and physicians for a median of 48.1 months.
Main Results:
- Seven procedure-related complications (4%) occurred.
- 79% of patients remained asymptomatic during follow-up.
- Recurrence of accessory pathway tachycardia was observed in 4% of patients, typically within the first month post-ablation.
Conclusions:
- Radiofrequency catheter ablation offers a low long-term recurrence rate for accessory pathway-mediated tachycardia.
- Late-onset symptoms (after 3 months) are more likely due to supraventricular arrhythmias from other causes, not accessory pathway recurrence.
Aims:
To evaluate the long-term clinical results of patients who underwent successful radiofrequency catheter ablation of a symptomatic drug-resistant accessory-pathway-mediated tachycardia.
Methods And Results:
Clinical follow-up was done by direct contact with the patients and their physicians. One hundred and eighty consecutive patients (113 males, 67 females) were followed during a median period of 48.1 months. There were seven procedure related complications (4%). During the follow-up period, 79% of the patients remained asymptomatic; 14% complained of short bouts of palpitations due to isolated or short runs of atrial or ventricular premature beats; 7% had sustained palpitations due either to accessory pathway recurrence (4%) or supraventricular tachyarrhythmias not associated with an accessory pathway (3%). Symptoms due to accessory pathway recurrence appeared either in the first month following the ablation or at least later than 3 months when sustained supraventricular arrhythmias occurred related to another cause.
Conclusions:
Initially successful radiofrequency catheter ablation has a low, long-term recurrence rate (4%). Recurrence of accessory-pathway-mediated tachycardia is observed during the first month while later symptoms suggest supraventricular arrhythmias from another cause.
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