RADIOFREQUENCY ABLATION OF KENT BUNDLES - INITIAL EXPERIENCE IN 33 PATIENTS

The authors report their experience in endocavitary radio-frequency ab lation of 37 secondary pathways carried out in 33 consecutive patients . The indications for radical treatment were based solely on clinical arguments in 15 patients, on a combination of disabling signs and thre atening electrophysiological signs in 17 patients and on high retrogra de permeability in 1 asymptomatic patient. Endocavitary exploration re vealed 26 left lateral sites, 7 posterior paraseptal sites and 4 right lateral sites. The procedure was successful in 88 % of cases. Electro physiological follow-up, carried out routinely in all the patients 2 m onths after the procedure, revealed a single recurrence (3 %) which wa s treated by radio-frequency again, this time with a successful outcom e. There was only one complication, a complete AVBBB following ablatio n of a left posterior paraseptal Kent's bundle, which required a perma nent pacemaker. These results were similar to those reported in the li terature and clearly demonstrate the efficacy of radio-frequency treat ment of the secondary pathways, with a moderate risk of complication. These results were similar to those reported in the literature and cle arly demonstrate the efficacy of radio-frequency treatment of the seco ndary pathways, with a moderate risk of complication. Recent advances in the field of endocavitary ablation have made it possible to change the method of handling symptomatic Wolff-Parkinson White syndromes, by enlarging the indications for radical treatment in order to enhance t he comfort and quality of life of the patient.