Long-term results and learning curve for radio frequency ablation of accessory pathways

Radio frequency (RF) catheter ablation of accessory pathways represents an interventional method in modern cardiology that has become the first-line treatment for patients with symptomatic WPW-syndrome. The aim of this study was to analyze: (1) the learning curve for the ablation procedure; (2) procedural parameters and success; and (3) personal assessment of the treatment by the patients. Learning curve analysis included 195 consecutive patients, who underwent ablation between 1991 and 1996. The follow-up survey included 65 consecutive patients. The analysis of the procedural parameters showed significant improvement after 100 cases, implying a completion of the learning curve at this point. Long-term follow-up showed a high success rate for all pathways (95.4%). All procedure parameters indicated significantly higher degree of difficulty for right free-wall and septal pathways, with lowest long-term success rate for right-sided pathways (78.6%). Personal assessment survey showed high acceptance of the treatment; the procedure was described as a significant improvement of overall quality-of-life by 92.3% of patients. The results of this study confirm the catheter ablation of accessory pathways--in particular after completion of the learning curve--as a low-risk and highly efficient treatment for symptomatic WPW-syndrome, with a high degree of patient-related acceptance.