Comparison of direct-current and radiofrequency ablation of free wall accessory atrioventricular pathways in the Wolff-Parkinson-White syndrome.

Abstract

To evaluate and compare the safety and efficacy of catheter-mediated direct-current (DC) or radiofrequency (RF) ablation in patients with free wall accessory atrioventricular pathways, 95 patients with free wall accessory atrioventricular pathway-mediated tachyarrhythmias underwent catheter ablation. Immediately after ablation, 27 of 30 accessory pathways (90%) were ablated successfully with DC, but 2 of the 27 had early return of conduction and received a second ablation session; 3 of 8 (38%) and 57 of 62 (92%) accessory pathways were ablated successfully with RF through a small-tip (2 mm) and a large-tip (4 mm) electrode catheter, respectively. Complications in DC ablation included transient hypotension (2 patients) and pulmonary air-trapping (2 patients) and in RF ablation, cardiac tamponade (1 patient) and suspicious aortic dissection (1 patient); myocardial injury and proarrhythmic effects were more severe in DC ablation. Procedure and radiation exposure time were significantly longer in RF ablation (DC, 3.6 +/- 0.2 hours, 34 +/- 4 minutes; RF 4.2 +/- 0.5 hours, 50 +/- 10 minutes). This study confirms that RF ablation is associated with little morbidity and few complications, and RF ablation with a large-tip electrode catheter is an effective and relatively safe nonsurgical method for treatment of free wall accessory atrioventricular pathway-mediated tachyarrhythmias.

• Authors: S A Chen, W P Tsang, C P Hsia, D C Wang, C E Chiang, H I Yeh, J W Chen, C W Chiou, C T Ting, C W Kong
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 70 Issue 3 Pg. 321-6 (Aug 01 1992) ISSN: 0002-9149 [Print] United States
• PMID: 1632396 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Electrocoagulation (adverse effects, methods)
• Heart Conduction System (abnormalities, surgery)
• Humans
• Middle Aged
• Radio Waves
• Wolff-Parkinson-White Syndrome (surgery)