Abstract

CENTURION, Osmar Antonio. Two decades of succesful follow-up of the first radiofrequency catheter arrhythmia ablation done in the history of medicine in Paraguay. Mem. Inst. Investig. Cienc. Salud [online]. 2015, vol.13, n.2, pp.107-113. ISSN 1812-9528.  https://doi.org/10.18004/Mem.iics/1812-9528/2015.013(02)108-114.

Endocardial mapping has been widely used for the analysis of supraventricular tachycardias during electrophysiological study. This mapping and the detailed analysis of endocardial electrograms and conduction intervals allow for the localization of the site of origin of the arrhythmias thus facilitating curative treatment with radiofrequency catheter ablation. The case describes our 29 years old patient with manifested Wolff-Parkinson-White syndrome that presented frequent, documented episodes of paroxysmal supraventricular tachycardia with serious hemodynamic alteration that needed frequent admissions to intensive care units despite the use of 2-3 antiarrhythmic agents per day. A detailed endocardial mapping showed a left posteroseptal accessory pathway. The accessory pathway effective refractory period is 240 ms. The first radiofrequency emission through an adequately positioned radiofrequency catheter terminated the tachycardia. The tachycardia was rendered non-inducible thereafter. In two decades of follow-up, the patient has not presented a single episode of tachycardia. The definite cure provided by the radiofrequency ablation produced a total, dramatic, and beneficial change in the quality of life of the patient. The clinical and socio-economical benefits are greater the earlier the arrhythmia ablation procedure is performed.

Keywords : Radiofrequency ablation of the Kent accessory pathway; electrophysiological study; wolff-Parkinson-White síndrome; paroxysmal supraventricular tachycardia.

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