Cryoablation of the accessory pathway in Wolff-Parkinson-White syndrome: initial results and long term follow up

Cryoablation of the accessory pathway was used in the management of 20 patients with pre-excitation syndromes. All patients had presented with paroxysmal atrioventricular reentrant tachycardia; in addition, six had experienced atrial fibrillation. In 16 patients pre-excitation was overt and in four...

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Bibliographic Details
Published in:British Heart Journal 1988-04, Vol.59 (4), p.453-457
Main Authors: Rowland, E, Robinson, K, Edmondson, S, Krikler, D M, Bentall, H H
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Cryosurgery
Electrophysiology
Female
Follow-Up Studies
Heart
Heart - physiopathology
Heart Conduction System - surgery
Humans
Male
Medical sciences
Middle Aged
Postoperative Complications
Postoperative Period
Wolff-Parkinson-White Syndrome - physiopathology
Wolff-Parkinson-White Syndrome - surgery
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Summary:Cryoablation of the accessory pathway was used in the management of 20 patients with pre-excitation syndromes. All patients had presented with paroxysmal atrioventricular reentrant tachycardia; in addition, six had experienced atrial fibrillation. In 16 patients pre-excitation was overt and in four the accessory pathway was concealed. Intraoperative epicardial and endocardial mapping showed 10 left free wall pathways, seven septal pathways, and four right free wall pathways. One patient had two right free wall accessory pathways. There was one postoperative death (from a ruptured cerebral haemangioma) and one patient had transient hemiparesis. There was early recurrence of arrhythmia or pre-excitation in six patients and five of these were among the first ten in the series. Four of the six underwent successful reoperation; 17 patients remain symptom free of all antiarrhythmic treatment. Two patients did not undergo reoperation--one became symptom free on drugs that had previously been ineffective and the other received an antitachycardia pacemaker. The mean period of follow up was six years. Accessory pathway function was not restored and atrioventricular nodal function was preserved in all patients, demonstrating the feasibility of this technique in the long term management of patients with the pre-excitation syndrome.
ISSN:0007-0769
1355-6037
1468-201X
2053-5864
DOI:10.1136/hrt.59.4.453