Frequency and long term follow up of valvar insufficiency caused by retrograde aortic radiofrequency catheter ablation procedures

Objective-To assess the frequency of valvar complications caused by left si ded radiofrequency catheter ablation using the retrograde aortic technique. Methods-179 patients (118 male) with a mean (SD) age of 43 (17) years under went 216 procedures at one centre. The target of the ablation was an access ory atrioventricular pathway in 144 patients, the atrioventricular junction in 29 patients, and a ventricular tachycardia in six patients. In 25 patie nts structural heart disease was identified before the procedure (ischaemic heart disease 10, cardiomyopathy nine, valvar three, other three). Echo/Do ppler examinations were performed the day before the procedure and within 2 4 hours postablation; the investigations were all reviewed by the same inve stigator. Patients with identified valvar injury caused by the procedure we re followed for 42 (7) months. Results-Valvar injury caused by the ablation procedure was identified in fo ur young (age 30 (8) years), otherwise healthy patients with left lateral a trioventricular accessory pathways. Mild mitral insufficiency with a centra l regurgitation jet was detected in two patients and remained unchanged at follow up. Mild aortic insufficiency was detected in another two patients. In one of these the regurgitation jet was central and remained unchanged at follow up. In one patient the regurgitation jet was located between the no ncoronary and left cusps in relation to a loosely attached structure. Both the structure and the valvar regurgitation disappeared during follow up. No clinical complications occurred in any of the patients during follow up. Conclusion-In this study, the frequency of valvar complications after left sided radiofrequency catheter ablation using the retrograde aortic techniqu e was 1.9%.