Radiofrequency catheter ablation of accessory atrioventricular pathways

Radiofrequency catheter ablation has established as the first line therapy for the curative treatment of patients with accessory pathways. For left-si ded accessory pathways, the retrograde approach over the aortic valve is co mmonly used for ablation of the Ventricular insertion. For right-sided and septal accessory pathways, the atrial insertion is usually approached from the right atrium. Atrioventricular accessory pathways irrespective of the e xact localization can be successfully ablated in more than 90-95 % of all c ases. Severe complications associated with the ablation procedure are rare and occur in approximately 2-3 % of patients treated. The recurrence rate a fter successful ablation is approximately 5-10 %. Recurrences of accessory pathway conduction occur almost exclusively within the first 3 months follo wing successful ablation whereas late recurrences are rare. Because of the favorable efficacy risk profile, radiofrequency catheter abl ation can be recommended as the first line therapy to all symptomatic patie nts with accessory atrioventricular pathways.