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Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve
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Abstract
Background and aim: The aim of this study was to examine contemporary results of accessory pathway (AP) ablation in a sizeable number of patients, focusing on periprocedural complications and the learning curve.
Methods: We performed a retrospective cohort study of consecutive AP ablation procedures at three centresby the same operator. In total 629 electrophysiological studies and 610 AP ablation procedures were performed in 570 patients (age: 33 ± 18.9 years).
Results: There was one (0.16%) serious and there were 14 (2.3%) minor periprocedural complications. Five hundred and ninety APs were successfully ablated: single/multiple procedure success was 93.4%/96.7%, while the average fluoroscopy time was 13.5 min. There was significantly higher success and less fluoroscopy use with increased experience, while periprocedural complications seemed evenly distributed over the years. The learning was most pronounced for the first 120 cases. However, the learning curve fully flattened only after approximately 400 ablations.
Conclusions: This study suggests that in the modern era AP ablation is safer than it was in the first two decades after the introduction of catheter ablation of APs. Perhaps, in experienced centres there should be a lower threshold for referring asymptomatic/mildly symptomatic patients with pre-excitation for electrophysiological study.
Abstract
Background and aim: The aim of this study was to examine contemporary results of accessory pathway (AP) ablation in a sizeable number of patients, focusing on periprocedural complications and the learning curve.
Methods: We performed a retrospective cohort study of consecutive AP ablation procedures at three centresby the same operator. In total 629 electrophysiological studies and 610 AP ablation procedures were performed in 570 patients (age: 33 ± 18.9 years).
Results: There was one (0.16%) serious and there were 14 (2.3%) minor periprocedural complications. Five hundred and ninety APs were successfully ablated: single/multiple procedure success was 93.4%/96.7%, while the average fluoroscopy time was 13.5 min. There was significantly higher success and less fluoroscopy use with increased experience, while periprocedural complications seemed evenly distributed over the years. The learning was most pronounced for the first 120 cases. However, the learning curve fully flattened only after approximately 400 ablations.
Conclusions: This study suggests that in the modern era AP ablation is safer than it was in the first two decades after the introduction of catheter ablation of APs. Perhaps, in experienced centres there should be a lower threshold for referring asymptomatic/mildly symptomatic patients with pre-excitation for electrophysiological study.
Keywords
accessory pathway, pre-excitation, ablation, complications, learning curve
About this articleTitle
Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve
Journal
Kardiologia Polska (Polish Heart Journal)
Issue
Pages
804-810
Published online
2017-08-17
Page views
310
Article views/downloads
493
DOI
10.5603/KP.2017.0153
Bibliographic record
Kardiol Pol 2017;75(8):804-810.
Keywords
accessory pathway
pre-excitation
ablation
complications
learning curve
Authors
Marek Jastrzębski
Paweł Moskal
Maciej Pitak
Kamil Fijorek
Andrzej Rudziński
Danuta Czarnecka
