Radiofrequency catheter ablation in the treatment of Wolff-Parkinson-White syndrome

Introduction: Tachyarrhythmias in Wolf Parkinson White (WPW) syndrome, can be a life threatening factor. Antiarrhythmic drug therapy in this syndrome, has not been completely acceptable. Efficacy, safety and economy of Radio Frequency Catheter Ablation (RFCA) in western studies, has made it as the treatment of choice. In the present study, efficacy of RFCA in the ablation of accessory pathway(s) and also, its complication and recurrence rate were studied in Modarres Hospital, Tehran, Iran. Methods: In this clinical trial study, 63 patients with WPW syndrome and over 16 years old were selected. Accessory pathway(s) in Electrophysiologic Study (EPS) laboratory was confirmed and ablation with radiofrequency energy was performed. If successful, the patients were followed up for one year. The results were analyzed with Mc Nemar’s method and p<0.05 was considered significant. Results: Out of sixty three patients, 36 were male and 27 were female with the mean age of 38.4±14.9 years. The most common accessory pathways were in left free wall (52.4%) and then in septal region (31.7%), right free wall (9.5%) and multiple accessory pathways (6.3%). The success rate in the ablation of accessory pathways, in general, was 90.5%. Maximum success was in septal pathways (95%) and minimum in right accessory pathways (83%) and in multiple accessory pathways (75%). There was no meaningful relationship between efficacy of RFCA and age or sex. There was not any complication. The recurrence rate in a one year period was 4.8%. Conclusion: In this study, the result of RFCA in ablation of accessory pathway(s) and treatment of arrhythmia was comparable with previous western studies. So in our country, RFCA as the first therapy of choice in WPW syndrome is recommended