[Transcatheter ablation of atrioventricular accessory pathways. Immediate results and long-term follow-up]

We present the immediate results and follow-up, from our initial serie of patients, where radiofrequency was attempted to ablate atrio-ventricular accessory pathways. Initiation policy included direct current-shocks following every unsuccessful radiofrequency session. Initial ablation success rate with radiofrequency solely was 75% (17/22), same as when direct current-shocks were associated 80% (8/10); but accessory pathway conduction recurrence was present only in this latter (6/10). During follow-up period of 18 to 25 months, from the recurrence group, one patient had spontaneous delta-wave disappearance, and four more required two to three ablation sessions. Permanent elimination with both methods was attained in 91% (20/22 pathways), and all patients remain asymptomatic, and drug free. There were one acute major complication, but no deaths. Because of its superior initial success rate, minor technical requirements, and their economical implications, radiofrequency catheter ablation of accessory pathways is the first choice of treatment. At our institution, direct current-shock remain an alternative method whenever a serious tachycardia prevents radiofrequency treatment.