Long-term results of radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome.

Y. J. Chen, S. A. Chen, C. T. Tai, C. E. Chiang, S. H. Lee, C. W. Chiou, K. C. Ueng, Z. C. Wen, W. C. Yu, J. L. Huang, A. N. Feng, M. S. Chang

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Abstract

BACKGROUND: Information about the long-term results of radiofrequency catheter ablation, electrophysiologic characteristics of differently located accessory pathways, and the difference between a single accessory pathway and multiple accessory pathways was limited. METHODS: Nine hundred and thirty-one patients with 1016 accessory pathways (APs) received electrophysiologic study and radiofrequency catheter ablation between July 1, 1989 and June 31, 1996. Group 1 included 856 (91.9%) patients with a single AP and Group 2 included 75 (8.1%) patients with multiple APs. The follow-up period was 48 +/- 37 months (range, 2 to 84 months). RESULTS: Nine hundred and thirteen patients (98.1%) had successful ablation with a complication rate of 1.5%. In Group 1, left free wall pathways were ablated with fewer radiofrequency pulses, shorter procedure time, shorter radiation exposure time and a lower recurrence rate than those at other locations. Comparisons between Group 1 and Group 2 showed that the latter had higher incidences of antidromic tachycardia (3% vs 13%, p <0.05) and atrial flutter/fibrillation (26% vs 37%, p <0.05). Regarding radiofrequency catheter ablation, Group 2 needed more radiofrequency pulses (8.7 +/- 7.8 vs 5.5 +/- 7.7, p <0.001), longer procedure time (3.3 +/- 1.4 vs 2.1 +/- 1.0 hours, p <0.05) and radiation time (49 +/- 27 vs 29 +/- 19 minutes, p <0.001), and a higher recurrence rate (10.6% vs 3.3%, p <0.005) than those in Group 1. Thirty-six patients (4%) with recurrence had more right-side pathways than those without recurrence. In addition, difficult ablation (longer procedure time, longer radiation time and more radiofrequency pulses) was associated with a higher recurrence rate. CONCLUSIONS: These findings demonstrated that a high success rate with a low recurrence and low complication rate of radiofrequency catheter ablation could be achieved in a large population with APs during a long follow-up period.

Original languageEnglish
Pages (from-to)78-87
Number of pages10
JournalChinese Medical Journal (Taipei)
Volume59
Issue number2
Publication statusPublished - Feb 1997
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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    Chen, Y. J., Chen, S. A., Tai, C. T., Chiang, C. E., Lee, S. H., Chiou, C. W., Ueng, K. C., Wen, Z. C., Yu, W. C., Huang, J. L., Feng, A. N., & Chang, M. S. (1997). Long-term results of radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome. Chinese Medical Journal (Taipei), 59(2), 78-87.