Delayed success following radiofrequency catheter ablation

Two patients who underwent attempted radiofrequency catheter ablation of an atrioventricular accessory pathway experienced delayed abolition of pathway conduction. During the procedures there was transient block in the accessory pathway following multiple ablation attempts at closely spaced sites. Both patients showed evidence of preexcitation at the conclusion of the ablation session but neither showed evidence of accessory pathway conduction during a second electrophysiological study. These observations demonstrate that in patients in whom transient block of the accessory pathway is produced, continued evolution of radiofrequency energy lesions may result in the eventual success of an initially unsuccessful ablation session.