CLINICAL UTILITY OF ROUTINE TRANSTHORACIC ECHOCARDIOGRAPHIC STUDIES AFTER UNCOMPLICATED RADIOFREQUENCY CATHETER ABLATION - A PROSPECTIVE MULTICENTER STUDY

Unsuspected cardiac complications have been occasionally identified on postablation echocardiographic studies; however, the clinical utility of route echocardiographic studies following uncomplicated radiofrequ ency catheter ablation procedures has not been established. Two-dimens ional/Doppler echocardiographic studies obtained preablation (within 3 months of the procedure) in 355 consecutive patients (180 males and 1 75 females, mean age 37 +/- 21 years) were compared to postablation (w ithin 24 hours of the procedure) studies obtained after a total of 387 uncomplicated RF catheter ablation procedures for AV node slow pathwa y (n = 120), accessory AV pathways (n = 214), and complete AV junction (n = 39). Postablation studies identified 6 new cases (1.5%) of new w all motion abnormalities, and 3 additional patients had septal wall mo tion abnormalities during ventricular pacing. LVEF remained unchanged from baseline (62 +/- 10 vs 62 +/- 11). A small pericardial effusion w as detected after 11 procedures (2.8%), and there were 9 (2.3%), 21 (5 .4%), and 20 (5.2%) new findings of mild (1+) aortic, mitral, and tric uspid regurgitation, respectively; and no cases of significant valvula r dysfunction in any patient. There were no new cases of cavity thromb us. There was no clear relationship between postablation echocardiogra phic findings and the type and approach to ablation, and no patient ha d any clinical sequelae possibly related to any of the new echocardiog raphic findings during a mean follow-up of 15 +/- 6.0 months (range 1- 26 months). Routine transthoracic echocardiographic studies after unco mplicated RF catheter ablation procedures identify occasional minor ab normalities that (1) may or may not be procedure related, (2) are of n o apparent clinical consequence, and (3) thus appear to be of limited value.