Recurrence of conduction following radiofrequency catheter ablation procedures: Relationship to ablation target and electrode temperature

Hugh Calkins, Eric Prystowsky, Ronald D. Berger, J. Philip Saul, Lawrence S. Klein, L. Bing Liem, S. K.Stephen Huang, Paul Gillette, Patrick Yong, Mark Carlson

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: More than 1 in 10 patients may develop recurrence of conduction after undergoing a successful radiofrequency catheter ablation procedure. The physiologic basis for recurrence following successful ablation procedures remains uncertain. The purpose of this study was to evaluate the role of electrode temperature as a predictor of recurrence following radiofrequency catheter ablation procedures. Methods and Results: The subjects of this study were 538 patients who underwent a successful attempt at radiofrequency catheter ablation of AV nodal reentrant tachycardia, an accessory pathway, and/or the AV junction. Patients were followed for a mean of 215 ± 138 days. Conduction recurred in 35 (6.5%) of the 538 patients. Recurrence of conduction occurred in 25 (9.3%) of 270 patients undergoing ablation of an accessory pathway, 7 (3.5%) of 201 patients undergoing ablation of AV nodal reentrant tachycardia, and in 3 (4.5%) of 67 patients undergoing ablation of the AV junction. The electrode temperature achieved at successful sites associated with recurrence was not different from the temperature achieved at successful sites without recurrence (61.1 ± 8,9 vs 61.6 ± 9.1; P = 0.8). The likelihood of developing a recurrence was higher following ablation of accessory pathways than following ablation of AV nodal reentrant tachycardia or the AV junction (P = 0.03). Patients experiencing a recurrence following ablation of an accessory pathway had longer procedure durations (P = 0.0001). Ablation of left free-wall pathways was associated with a lower incidence of recurrence as compared with all other locations (P = 0.008). Conclusion: The results of this study suggest that electrode temperature at the successful ablation site cannot be used to identify patients at highest risk of recurrence.

Original languageEnglish (US)
Pages (from-to)704-712
Number of pages9
JournalJournal of cardiovascular electrophysiology
Volume7
Issue number8
DOIs
StatePublished - 1996

Keywords

  • catheter ablation
  • radiofrequency
  • recurrence
  • temperature

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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