Catheter Ablation for Patients with Ventricular Preexcitation Syndromes

Abstract

The newly introduced method of catheter electrocoagulation of the atrioventricular (AV) [1,2] junction or accessory pathway [3,4] has provided a new treatment modality for patients with cardiac arrhythmias involving accessory pathways. Techniques for catheter electrocoagulation of the AV junction were introduced almost four years ago, while specific catheter techniques for accessory pathway ablation were introduced only two years ago. While the introduction of these techniques offers great promise for patients with tachycardia utilizing an accessory pathway, the experience, to date, is limited and the follow-up is short. Therefore, definitive recommendations are not possible. In this chapter, we lean heavily on our own experience with the ablative techniques since available reports of these procedures are sparse [3–7]. The purpose is to describe the currently available catheter ablative techniques and explore use of these techniques in the management of patients with recurrent tachycardias associated with accessory pathways in whom tachyarrhythmia has proved refractory to antiarrhythmics and/or antitachycardia devices (Table 24–1).