SHORT AND MEDIUM-TERM OUTCOME AFTER RADIO FREQUENCY ABLATION OF THE ATRIOVENTRICULAR JUNCTION

The aim of this retrospective study was to assess short and long-term mortality and morbidity after radiofrequency ablation of the atriovent ricular junction in patients with supraventricular arrhythmias resista nt to treatment. This cooperative series included 91 patients (47 men, mean age 68 +/- 9 years). The arrhythmia was paroxysmal in 56 % of ca ses. The mean duration of symptoms was 67 +/- 61 months and 45 patient s (49.4 %) were in the NYHA Classes ill and IV. An escape rhythm was p resent in 58 patients with a mean frequency of 39 +/- 9/min. Early com plications were observed in 5 patients (venous thromboses, pulmonary e mbolism, mild pericardial effusion and haemothorax). The hospital mort ality was 4 patients (4.4 %). Death was of cardiac origin in 1 case (c ardiac failure). The mean follow-up of patients was 14.5 +/- 8.6 month s. Eleven patients died during this period, 8 of cardiac causes : card iac failure (3 cases), sudden death (3 cases), thrombosis of a valve p rosthesis (1 patient) and major electrolyte disturbances causing loss of stimulation in 1 case. Six patients had recurrences. Long-term morb idity was either related to cardiac pacing (3 cases) or cardiac failur e (3 cases), Thirteen patients were in NYHA Classes III or IV at the e nd of follow-up. The authors conclude that radiofrequency ablation at the atrioventricular junction is an effective method of treating resis tant supraventricular arrhythmias. Complications are not frequent but mortality appears to be high, probably due to the presence of advanced cardiac disease in the majority of cases. Sudden death seems to be ra re and unrelated to pacing defects.