[Catheter ablation of accessory pathways and atrioventricular nodal reentry tachycardia]

Radiofrequency current catheter ablation has gained acceptance as primary long-term therapy for patients with symptomatic accessory pathways and symptomatic atrioventricular nodal reentrant tachycardia (AVNRT) with frequent recurrences. In both arrhythmias, curative treatment is possible in more than 90% of cases at a low complication rate although an incidence of about 1% complete AV block after slow pathway ablation has to be taken into account when this therapy is considered. The recurrence rate is 3-10% for accessory pathways and 0-15% for AVNRT. The high success rate of catheter ablation has already led to a shift in the indications for the procedure where the percentage of patients with accessory pathways is decreasing and there is an increase of patients with AVNRT and newer indications (atrial flutter, focal atrial tachycardias).