Abstract
Background:Radiofrequency catheter ablation(RFCA) has now become the
standard and effective therapy for paroxysmal supraventricular
tachycardias, but the success rates of ablation were reported different
in a large number of single-centers. It is estimated that there are
still thousands of cases of relapse in China every year, among which the
main cases are of accessory pathways(Aps) mediated
tachycardia.Objective: The purpose of this study was to compare the
efficacy and safety of two different radiofrequency ablation strategies,
improve ablation method and reduce the recurrence rate of ablation of
accessory pathway mediated tachycardia.Method and Result: 1712
consecutive cases of AVRT with 1741 accessory pathways were analyzed in
our retrospectively observational study. They were divided into group S
and group M (undergone complementary ablation) according to different
strategies of RFCA. 882 cases with 898 Aps were enrolled in group S
versus 830 cases with 843 Aps in group M. The results showed the
cumulative recurrence number (rate) at the 1st, 3rd, 6th, 12th, and 24th
month after ablation were 4(0.5%) vs 17 (1.9%) p=0.007, 5(0.6%) vs
27(3.0%) p=0.000, 6(0.7%) vs 34 (3.8%) p=0.000, 6(0.7%) vs 58
(6.5%) p=0.000, 7(0.8%) vs 63(7.1%) p=0.000, respectively;
Complications of chest pain, over vasovagal reaction, steam pop, angina
pectoris, and embolism were rare in both groups; No Valve damage,
myocardial infarction, cardiac tamponade, periprocedural death or other
serious adverse events occurred in the both groups. Conclusions:The
strategy of complementary ablation significantly reduced the recurrence
rate of radiofrequency ablation of accessory pathway without increasing
the risk of complications.