[Incidence of short-term arrhythmias after endocavitary fulguration]

The potential short-term arrhythmogenic role of catheter-mediated electrical ablation was studied in 61 patients of mean age 44 years (range 15-80 years) who underwent this procedure for Wolff-Parkinson-White syndrome (36 patients) or ventricular tachycardia (VT, 25 patients). Continuous ECG monitoring was pursued during the 24 hours that preceded and followed ablation. Only bursts of 3 consecutive beats or more were considered significant. Recordings were performed with either a Hewlet Packard 78720 A arrhythmia recorder or a Holter readout system (Oxford Medilog 2, Marquette). In 36 patients with an accessory conduction pathway the 160 J were delivered at the annulus fibrosus cordis. Post-ablation recordings showed: VT bursts in 16 patients (17%); the bursts disappeared in every case before 3 days; in 3 patients the electrogram at the site of ablation was predominantly ventricular (p less than 0.05); frequent or subintrant attacks of reciprocal orthodromic rhythm (RR); in 3 cases RR began on simple variations of heart rate; it reflected a loss of the anterograde conduction hidden in the accessory pathway and required a second ablation; in 1 case RR initiated by VT bursts revealed the presence of a second accessory pathway; atrial tachycardia bursts, spontaneously resolved, in 4 patients (11%). No atrial fibrillation of flutter was recorded. In patients with VT ablation was delivered in the right ventricle (160 J, 9 patients) or in the left ventricle (240 J, 16 patients). The effects of ablation could only be interpreted in 21 patients who underwent 25 ablations.(ABSTRACT TRUNCATED AT 250 WORDS)