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Delayed Effects of Radiofrequency Energy on Accessory Atrioventricular Connections
Author(s) -
LANGBERG JONATHAN J.,
BORGANELLI S. MARK,
KALBFLEISCH STEVEN J.,
STRIGKBERGER S. ADAM,
GALKINS HUGH,
MORADY FRED
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb04574.x
Subject(s) - medicine , ablation , radiofrequency catheter ablation , radiofrequency ablation , catheter ablation , accessory pathway , electrical conduction system of the heart , cardiology , surgery , electrocardiography
The purpose of this study was to determine the incidence and characteristics of delayed effects on conduction through accessory atrioventricular (AV) connections after apparently successful attempts at radiofrequency catheter ablation. Among 450 patients who had 471 accessory AV connections, the ablation procedure was unsuccessful in 26 patients (6%), as defined by persistent conduction through the accessory AV connection 60 minutes after the final application of radiofrequency energy. In 6/26 unsuccesfully treated patients (24%), conduction through the accessory AV connection disappeared on a delayed basis. At least once during the ablation procedure, conduction through each of these 6 accessory AV connections was transiently eliminated for 10 seconds to 60 minutes. Five of these accessory AV connections were left‐sided and one was posteroseptal; one was concealed and five were manifest. Conduction through the accessory AV connection disappeared on a delayed basis 6–18 hours after the ablation procedure in 4 patients, and at some time between 1–5 days or 1–60 days in the other 2 patients. In 2 patients, the delayed effect was only transient, while in 4 patients, conduction through the accessory AV connections did not return during 5–23 months of follow‐up. In conclusion, up to 15% of patients who undergo an apparently unsuccessful attempt at radiofrequency ablation of an accessory AV connection may later manifest a permanent loss of conduction through the accessory AV connection.