[Radiofrequency ablation of Kent's pathways. Apropos of 30 cases]

Radiofrequency catheter ablation is a modern radical treatment of the Wolff-Parkinson-White (WPW) syndrome. The authors report their experience of this method in 30 consecutive patients (12 women, 18 men, mean age 34.2 +/- 13 years, range 14 and 63 years) with the WPW syndrome poorly controlled by antiarrhythmic therapy in 27 out of 30 cases. An average of 10.1 applications (1-33) was necessary to suppress anterograde and retrograde conduction in 26 of the 30 patients during the first session (87% success rate). At the time of effective ablation, the average atrioventricular interval was 41 ms (35-55) and in the two patients with a retrograde Kent bundle, the average ventriculoatrial interval was 72 ms (70 and 75 ms). The average duration of the procedure was 3.5 hours (45 mins to 7 hours) with an average fluoroscopy time of 61.6 minutes (9-182 minutes). There were four complications: one pneumothorax, one subacute femoral arterial obstruction and in two patients with a left Kent bundle, one TIA which regressed within 1 hour and one hemiplegia which regressed in 24 hours. After an average follow-up period of 8.3 months (2-16 months) the 26 patients are asymptomatic without any treatment. Radiofrequency catheter ablation therefore seems to be an effective method with a low morbidity for the radical treatment of symptomatic or high risk WPW syndromes.