Analysis Of The Failure Of Radiofrequency Catheter Ablation In Paroxysmal Supraventricular Tachycardia

Objective:To explore the reasons for the failure of radiofrequency catheter ablation(RFCA) in paroxysmal supraventricular tachycardia(PSVT).Methods:The clinical efficacy of RFCA for 1026 patients with PSVT was retrospectively analyzed,including 463 cases of atrioventricular nodal reentrant tachycardia (AVNRT),461 left accessory pathways,102 right accessory pathways.Results:1. Of 1026 patients with PSVT,991 cases(96.6%)successfully underwent RFCA operation for the first time.2. There were 35 unsuccessful cases,including 13 left accessory pathways,13 right accessory pathways and 9 cases of atrioventricular nodal reentrant tachycardia(AVNRT).3. Of the 35 unsuccessful cases,26 cases(74.3%) were caused by the beginners and 9 cases(25.7%) were caused by the technical experts.19 patients were cured undergoing re-ablation by the technical experts,the total success rate of ablation PSVT was 98.4%(1010/1026).4. During the 35 unsuccessful cases, there were 3 patients complicated withⅢ°atrioventricular block(AVB),1 case complicated with pericardial occlusion.Conclusion:1. For the beginners,the main reasons for the failure of RFCA were the unskilled catheter operation and undetermined diagnosis. 2. For the technical experts,the main reasons for the failure of RFCA were anatomical abnormalities leading to difficult catheter operation and inaccuracy of targeted electrogram.