open access

Vol 75, No 8 (2017)
Original articles
Published online: 2017-08-17
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Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve

Marek Jastrzębski, Paweł Moskal, Maciej Pitak, Kamil Fijorek, Andrzej Rudziński, Danuta Czarnecka
DOI: 10.5603/KP.2017.0153
·
Kardiol Pol 2017;75(8):804-810.

open access

Vol 75, No 8 (2017)
Original articles
Published online: 2017-08-17

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.

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Keywords

accessory pathway, pre-excitation, ablation, complications, learning curve

About this article
Title

Contemporary outcomes of catheter ablation of accessory pathways: complications and learning curve

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 75, No 8 (2017)

Pages

804-810

Published online

2017-08-17

Page views

409

Article views/downloads

627

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

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