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Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome.
CMAJ 1994; 151(6):771-6CMAJ

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.

Authors+Show Affiliations

Department of Medicine, University of Western Ontario, London.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8087753

Citation

Thakur, R K., et al. "Radiofrequency Catheter Ablation in Patients With Wolff-Parkinson-White Syndrome." CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, vol. 151, no. 6, 1994, pp. 771-6.
Thakur RK, Klein GJ, Yee R. Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome. CMAJ. 1994;151(6):771-6.
Thakur, R. K., Klein, G. J., & Yee, R. (1994). Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome. CMAJ : Canadian Medical Association Journal = Journal De l'Association Medicale Canadienne, 151(6), pp. 771-6.
Thakur RK, Klein GJ, Yee R. Radiofrequency Catheter Ablation in Patients With Wolff-Parkinson-White Syndrome. CMAJ. 1994 Sep 15;151(6):771-6. PubMed PMID: 8087753.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiofrequency catheter ablation in patients with Wolff-Parkinson-White syndrome. AU - Thakur,R K, AU - Klein,G J, AU - Yee,R, PY - 1994/9/15/pubmed PY - 1994/9/15/medline PY - 1994/9/15/entrez SP - 771 EP - 6 JF - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne JO - CMAJ VL - 151 IS - 6 N2 - 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. SN - 0820-3946 UR - https://www.unboundmedicine.com/medline/citation/8087753/Radiofrequency_catheter_ablation_in_patients_with_Wolff_Parkinson_White_syndrome_ L2 - http://www.cmaj.ca/cgi/pmidlookup?view=reprint&amp;pmid=8087753 DB - PRIME DP - Unbound Medicine ER -