[Radiofrequency energy as treatment for arrhythmias in patients with accessory atrioventricular pathways]. / Radiofrequente energie als behandeling voor hartritmestoornissen bij patiënten met extra atrioventriculaire verbindingen.

ABSTRACT

OBJECTIVE: Evaluation of the use of radiofrequency energy to interrupt accessory atrioventricular pathways. DESIGN: Prospective study. SETTING: University Hospital Maastricht. METHOD: The outcome is presented of radiofrequency catheter ablation of accessory atrioventricular pathways in our first 50 consecutive patients, with a total of 54 accessory pathways. All but one patient suffered from symptomatic tachycardias. A catheter electrode was positioned next to the accessory pathway and 30 second pulses of 40 W radiofrequency energy were used to interrupt the connection. RESULTS: Complete block in conduction was accomplished in 44/54 (81%) of accessory pathways. No complications occurred. Success rate, procedure time and radiation dose were found to be related to the location of the accessory connection. The highest success rate was found in left free wall pathways (24/26; 92%), the lowest in right lateral pathways which seldom occur (1/4; 25%). The total procedure took 1-6 hours. The maximal duration of radiographic imaging was 2.5 hours. CONCLUSION: Although insufficient information on long-term efficacy is available, current results support the use of radiofrequency ablation of accessory pathways in institutions with expertise in the invasive management of cardiac arrhythmias. Technical improvements leading to reduction in procedure time and radiation dose will facilitate acceptance of this technique by patient and operator.