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CMAJ. 1994 Sep 15;151(6):771-6.

Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome.

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1
Department of Medicine, University of Western Ontario, London.

Abstract

OBJECTIVE:

To report on the experience with radiofrequency catheter ablation of accessory atrioventricular pathways in patients with Wolff-Parkinson-White syndrome in terms of the duration of fluoroscopy exposure to the patient and the operator and the effect of accessory-pathway location and operator experience on the success rate.

DESIGN:

Retrospective review.

SETTING:

Tertiary care university hospital.

PATIENTS:

Two hundred consecutive patients with Wolff-Parkinson-White syndrome who underwent radiofrequency catheter ablation between September 1990 and June 1992.

INTERVENTIONS:

Electrophysiologic study and radiofrequency catheter ablation.

MAIN OUTCOME MEASURES:

Success rate, duration of fluoroscopy, complications and long-term follow-up.

RESULTS:

Of the 224 accessory pathways in the 200 patients 135 were left free wall, 47 posteroseptal, 32 right free wall and 10 anteroseptal. The overall success rate increased from 53% in the first 3 months of the study period to 96% in the last 3 months. The success rate depended on the location of the accessory pathway. The duration of fluoroscopic exposure decreased from 50 (standard deviation [SD] 21) minutes in the first 3 months to 40 (SD 15) minutes in the last 3 months (p < 0.05). Complications occurred in 3.5% of the patients; they included hemopericardium, cerebral embolism, perforation of the right atrial wall, air embolism in a coronary artery and hematoma at the arterial perforation site. None of the complications resulted in death.

CONCLUSIONS:

With experience, radiofrequency catheter ablation of accessory pathways can have an overall success rate of more than 95% and a complication rate of less than 4%. Such rates make this procedure suitable for first-line therapy for patients with Wolff-Parkinson-White syndrome.

PMID:
8087753
PMCID:
PMC1337132
[Indexed for MEDLINE]
Free PMC Article
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