© 2002 by European Society of Cardiology
ELECTROPHYSIOLOGY
Radiofrequency ablation of multiple accessory pathways
Electrophysiology Department, Instituto Nacional de Cardiología ‘Ignacio Chávez’ México City, Juan Badiano 1, Tlalpan, 14080, México DF, Mexico
Abstract
The aim of the study was to review the clinical and electrophysiological characteristics and results of radiofrequency catheter ablation in patients with multiple accessory pathways to compare them with those of patients with single accessory pathways. Electrophysiological study and radiofrequency catheter ablation were performed in 1010 consecutive cases with Wolff Parkinson White Syndrome. Presence of multiple accessory pathways was documented in 31 patients (3·1%); 30 had two, and 1 had three accessory pathways. Of the 63 accessory pathways, 42 were manifest and 21 concealed. Nine patients had Ebstein's anomaly associated with atrioventricular bypass tracts. The most common combination was right posteroseptal with right free wall bypass tracts (15 patients with 30 accessory pathways). Fifty-one of the sixty-three accessory pathways (81%) were ablated successfully without complications. The duration of the procedure was 100±58 min and the fluoroscopic time 40±17 min. A follow up of 5±3 years after ablation, demonstrated recurrences of six accessory pathways (9·5%). In conclusion, patients with multiple accessory pathways can be treated by radiofrequency ablation in only one session with a high success rate although slightly less than that in patients with a single accessory pathway (81% vs 93%, P< 0·01). Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.
Key Words: Multiple accessory pathways, radiofrequency ablation, Wolff Parkinson White syndrome, atrioventricular re-entrant tachycardia
Correspondence: Pedro Iturralde, MD. Tel: 52-5513-37-40; E-mail: pedroi{at}yahoo.com
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