Efficacy and safety of the application of extensive ablation in patients
with atrioventricular re-entrant tachycardia (a retrospective study)
Abstract
Introduction: Radiofrequency catheter ablation (RFCA) has become the
standard effective therapy for supraventricular tachycardias, but the
reported success rates of ablation have differed across a large number
of single-center studies. The main reason for tachycardia recurrence is
accessory pathway (Ap)-mediated tachycardia, and the RFCA strategy may
be related to recurrence. This study aims to compare the efficacy and
safety of two different RFCA strategies for Ap-mediated tachycardia.
Methods : We compared patients (group M) who underwent RFCA at extensive
sites to patients (group S) with RFCA at a single site during the index
procedure for Ap-mediated tachycardia. The efficacy and safety were
assessed in the two groups. Results: A total of 882 patients with 898
Aps were enrolled in group S, and 830 patients with 843 Aps were
enrolled in group M. The results showed that the cumulative numbers of
recurrences (rates) at the 1st, 3rd, 6th, 12th, and 24th months after
ablation were 4 (0.5%) and 17 (1.9%), p<0.05; 5 (0.6%) and
27 (3.0%), p<0.05; 6 (0.7%) and 34 (3.8%),
p<0.05; 6 (0.7%) and 43 (4.8%), p<0.05; and 7
(0.8%) and 45 (5.0%), p<0.05 in group M and group S,
respectively. Complications of chest pain, overactive vasovagal
reaction, steam pop, and angina pectoris were rare in both groups. No
valve damage, cardiac tamponade, or other serious adverse events
occurred in either group. Conclusion: The strategy of performing
extensive ablation reduced the recurrence rate and need for subsequent
ablation of the Ap without increasing the risk of complications.