RADIOFREQUENCY CATHETER ABLATION - THEORE TICAL AND TECHNICAL ASPECTS

Radiofrequency currents produce circumscribed tissue necrosis by progr essive and localised heating. Endocardial application via the percutan eous approach with a specific electrophysiological catheter enables de struction of the anatomical substrate of many cardiac arrhythmias. The technique is well tolerated due to the absence of barometric phenomen a and general anaesthesia, and the possibility of modulating the energ y delivered, which explains why it has supplanted fulguration in most indications. The technological evolution aims to increase the lesional power and decrease the number of complications. This implies the deve lopment of catheters capable of delivering greater currents without th e risk of thrombus formation and of generators dependant on electrical or thermal parameters. The low incidence of complications reported by centres using the technique is based on an excellent understanding of the technique, the use of appropriate material, the surveillance of p arameters which allow detection of unwanted effects and the respect of a strict operation protocol. In the absence of these precautions, the wide diffusion of this technique, favorised by its low cost and relat ive simplicity, may be associated with an increase in the number of si de effects which could be lethal. This cannot be accepted in a techniq ue with such wide indications, including arrhythmias with a usually be nign long-term prognosis.