Introduction: Radiofrequency catheter (RF) ablation has become the routine treatment in most of the arrhythmias.
Hypothesis: The success rate is stable and the complication rate is very low during 23 years of RF ablation.
Methods and Results: Since 1991 and 2014, 1643 patient underwent 2076 RF ablation procedures (mean age 50±19, 835 male). During 17 years one physician and during 6 years 2 physicians performed the ablations. In 155 patients more than one arrhythmia mechanism was found and 61 patients had all the arrhythmias ablated in the original procedure. The indication for ablation was Atrio-Ventricular Nodal (AVN) reentrant tachycardia in 822 patients, Wolf Parkinson White Syndrome in 458 patients (including Mahaim and PJRT), atrial flutter in364 patients, atrial fibrillation in 101patients, atrial tachycardia in 126 patients, ventricular tachycardia in 76 patients and total AVN ablation in 56 patients. The final success rate was 96.2%. A second procedure was performed in 311 patients (19%) for a different arrhythmia (94 patients), recurrence (165 patients) repeated procedure because the first was not successful (44 patients) and repeated procedure when the first and the repeated procedures were not successful (8 patients). The second procedure free-survival increased significantly after the first 6 years (p<0.0001) (Figure). The complication rate was 1.1% including inadvertent atrioventricular block in 3 patient, peripheral arterio-venous complications in 5 patients, deep-venous thrombophlebitis in 2 patients and cardiac tamponade in 8 patients (mainly during early atrial fibrillation ablation-6 and early VT ablation in ARVC-2).
Conclusions: RF catheter ablation was safe and remained safe during 23 years of ablations, the success rate was stable and the secondary procedures significantly decreased mainly because decrease in the recurrence rate.
