Radiofrequency catheter ablation as primary therapy for supraventricular tachycardia.

BACKGROUND: Initial management of patients with supraventricular tachycardias has traditionally been with medications. More recently, radiofrequency catheter ablation offers curative therapy thus obviating the need for medications with potential side effects. The purpose of this study was to evaluate radiofrequency catheter ablation as an initial strategy to cure supraventricular tachycardias. METHODS: Radiofrequency catheter ablation was attempted as the initial therapy in 49 patients with supraventricular tachycardia, 25 with atrioventricular nodal reentrant tachycardia, 20 with atrioventricular reentrant tachycardia, two with both atrioventricular nodal reentrant tachycardia and atrioventricular reentrant tachycardia, and two with atrial tachycardia. RESULTS: Supraventricular tachycardia was rendered non-inducible in 48 of 49 (98%) patients undergoing radiofrequency catheter ablation. Thirteen of 14 patients returning for follow-up electrophysiologic study at 4.9 +/- 2.2 months had no evidence of recurrence. Three patients experienced documented recurrences of supraventricular tachycardia. One of these three patient's supraventricular tachycardia was rendered non-inducible after a final ablation session, and has had no recurrence after 24 months. The other two patients await repeat ablation. Two patients required treatment for atrial fibrillation which was documented prior to ablation. There were no complications or mortality from the procedure. CONCLUSIONS: Radiofrequency catheter ablation should be considered as first line therapy for symptomatic supraventricular tachycardia.