Retrospective Analysis of Radiofrequency Catheter Ablation of Tachycardia Caused by Multiple Accessory Pathways

Objective: To summarize electrophysiological characteristics through analyzing radiofrequency catheter ablation of tachycardia caused by multiple accessory pathways in 33 cases. Methods: This study included 33 patients, male 22, female 11, mean age [40.2±9.7(15～68)] years old. Electrophysiological examination and radiofrequency catheter ablation were finished one time. Results: Among 33 patients, double pathways 32 cases (left double pathways 18 cases, right double pathways 4 cases, bilateral pathways 10 cases); triple pathways 1 case (left pathway and right double pathways); 33 cases of all patients with 67 pathways were ablated successfully 40 times respectively after final diagnosis of tachycardia caused by multiple through electrophysiological examinations; rate of success was 100 percent; tachycardia with different shape and different frequency were evoked in 15 cases; Tachycardia with two different frequency in 6 cases was mapped and ablated respectively; another pathway in 5 cases, which was again confirmed after one pathway was ablated, was ablated; 6 cases of double pathways and 1 case of triple pathways had neither evidence of accessory pathway by electrophysiological examination, nor tachycardia excited after the first successfully ablation. However, tachycardia recurred from 1st month to 24th month after operation, confirmed by the electrophysiological reexamination, and ablated successfully again. During 5～72 months of follow-up, no complications was found. Conclusion: Diagnosis of multiple accessory pathways was basis of electrophysiological examination but manipulative complexity of electrophysiological multiple accessory pathways lead to practical difficulty. Bamboo-peeling method of ablation should be adopted. Sequences of multiple pathways ablation are: first, dominant accessory pathways are ablated before dormant accessory pathways done; second, left and right target points are mapped at the same time; third, lateral walls are ablated before septum done.