Role of catheter ablation for supraventricular tachyarrhythmias, with emphasis on atrial flutter and atrial tachycardia.

Abstract

Catheter ablation techniques using radiofrequency current have become an accepted form of treatment for a variety of supraventricular tachycardias. The results are excellent in patients with preexcitation syndromes and as the complication rate is low, catheter ablation has become the first line of treatment for these disorders. In atrioventricular nodal reentry, a selective ablation of the fast or slow pathway is feasible. Ablation of the slow pathway guided by electrophysiologic markers appears to be safer with the use of a very low number of radiofrequency applications. Experience with atrial tachycardia remains limited but developments appear promising. Lastly, atrial flutter has become a growing indication for catheter ablation techniques using anatomical approaches. A high success rate can be achieved initially, but the technique is limited by a 20% recurrence rate and the late occurrence of atrial fibrillation.