New Access for Radiofrequency Catheter Ablation of Left-Sided Atrioventricular Accessory Pathways

Safety and Efficacy of the Transradial Approach

Abstract

Background: The safety and efficacy of the transradial approach for radiofrequency catheter ablation (RFCA) of left-sided atrioventricular accessory pathways (APs) was evaluated in the present study. Methods and Results: Included were 40 consecutive patients with type A Wolff-Parkinson-White (WPW) syndrome who underwent RFCA via the radial artery route, and 30 patients with type A WPW syndrome who underwent RFCA via the transfemoral approach (controls) were retrospectively chosen for control. All 45 APs in the 40 patients were successfully ablated: 35 APs were successfully blocked with 1 ablation attempt, and the other 10 APs were ablated after 2-4 attempts. Compared with the transfemoral approach, the total procedure time for the transradial approach was longer (40 ±7.7 vs 32.4 ±8.7 min, P<0.05) and the fluoroscopic time was similar (7.2 ±2.2 vs 7.9 ±3.9 min, P>0.05). There were no vascular complications in the transradial group, but 2 patients in the transfemoral developed local hematoma. There was no recurrence of arrhythmia in either group. Conclusions: The transradial approach is a safe and effective access for RFCA of left-sided APs. (Circ J 2009; 73: 833 - 837)