Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 7-8, Pages: 458-464
https://doi.org/10.2298/SARH1108458M
Full text ( 381 KB)
Cited by
The occurrence of new arrhythmias after catheter-ablation of accessory pathway: Delayed arrhythmic side-effect of curative radiofrequency lesion?
Mujović Nebojša (Cardiology Department, Clinical Centre of Serbia, Belgrade)
Grujić Miodrag (Cardiology Department, Clinical Centre of Serbia, Belgrade + Faculty of Medicine, Belgrade)
Mrđa Stevan (Cardiology Department, Clinical Centre of Serbia, Belgrade)
Kocijančić Aleksandar (Cardiology Department, Clinical Centre of Serbia, Belgrade)
Mujović Nataša (Faculty of Medicine, Belgrade + Department for Physical Medicine and Rehabilitation, Clinical Centre of Serbia, Belgrade)
Introduction. New arrhythmias (NA) may appear late after accessory pathway
(AP) ablation, but their relation to curative radiofrequency (RF) lesion is
unknown. Objective. The aim of this study was to determine the prevalence and
predictors for NA occurrence after AP ablation and to investigate
pro-arrhythmic effect of RF. Methods. Total of 124 patients (88 males, mean
age 43±14 years) with Wolff-Parkinson-White syndrome and single AP have been
followed after successful RF ablation. Post-ablation finding of arrhythmia,
not recorded before the procedure, was considered a NA. The origin of NA was
assessed by analysis of P-wave and/or QRS-complex morphology, and,
thereafter, it was compared with locations of previously ablated APs.
Results. Over the follow-up of 4.3±3.9 years, NA was registered in 20
patients (16%). The prevalence of specific NAs was as follows:
atrioventricular (AV) block 0.8%, atrial premature beats 1.6%, atrial
fibrillation 5.4%, atrial flutter 0.8%, sinus tachycardia 4.8%, ventricular
premature beats (VPBs) 7.3%. Multivariate Cox-regression analysis
identified (1) pre-ablation history of pathway-mediated tachyarrhythmias >10
years (HR=3.54, p=0.016) and (2) septal AP location (HR=4.25, p=0.003), as
the independent predictors for NA occurrence. In four NA cases (two cases of
septal VPBs, one of typical AFL and one of AV-block) presumed NA origin was
identified in the vicinity of previous ablation target. Conclusion. NAs were
found in 16% of patients after AP elimination. In few of these cases, late
on-site arrhythmic effect of initially curative RF lesion might be possible.
While earlier intervention could prevent NA occurrence, closer follow-up is
advised after ablation of septal AP.
Keywords: radiofrequency ablation, catheter-ablation, accessory pathway
More data about this article available through SCIndeks