Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction - Final results of a prospective, multicenter clinical trial

Background-The purpose of this study was to evaluate the safety and efficac y of a temperature-controlled radiofrequency catheter ablation system. Methods and Results-The patient population included 1050 patients who had u ndergone ablation of atrioventricular nodal reentrant tachycardia (AVNRT), an accessory pathway (AP), or the atrioventricular junction (AVJ). Ablation was successful in 996 patients. The probability of success was highest amo ng patients who had undergone ablation of the AVJ, lowest in patients who h ad undergone ablation of an AP, and in between for patients who had undergo ne ablation of AVNRT. A major complication occurred in 32 patients. Four va riables predicted ablation success (AVJ, AVNRT, or left free wall AP ablati on and an experienced center). Four factors predicted arrhythmia recurrence (right free wall, posteroseptal, septal, and multiple APs). Two variables predicted development of a complication (structural heart disease and the p resence of multiple targets), and 3 variables predicted an increased risk o f death (heart disease, lower ejection fraction, and AVJ ablation). Conclusions-These findings may serve as a guide to clinicians considering t herapeutic options in patients who are candidates for ablation.