Late effects of radiofrequency fulguration. Report of five cases

Radiofrequency fulguration is the definitive treatment of several supravent ricular and ventricular arrythmias. During radiofrequency application, the conduction in a specific zone is interrupted as a consequence of cellular n ecrosis and edema. The disappearance of edema, minutes or hours after the p rocedure, allows the reappearance of conduction and arrythmias. On the othe r hand the definitive lesion is larger than the one caused acutely, due to the progression of the scar. We report five patients, in whom there was an apparent failure of the fulguration, since at the end of the procedure ther e was conduction in the fulgurated zone, the tachycardia was inducible or p re excitation and arrythmias reappeared during the follow up. All five were subjected to a new electrophysiological study and in all fulguration had b een effective. We conclude that these late effects of fulguration are due t o the slow progression of fibrosis, that continues days or weeks after dysf unction.