Key result
Surgical approaches remain preferred over radiofrequency ablation for eliminating epicardial or intramyocardial WPW accessory pathways.
Why the study?
Endocardial radiofrequency ablation for WPW syndrome might be ineffective when patients have epicardial or intramyocardial accessory pathways due to difficult catheter availability in the target zone.
Endocardial radiofrequency ablation is the primary approach for WPW syndrome, but may be ineffective for epicardial or intramyocardial accessory pathways.
Answers are grounded in this paper and cite their sources.
May require surgical referral for epicardial pathways refractory to endocardial RF; leaves open optimal selection and comparative outcomes data.
Radiofrequency ablation is the primary approach for the treatment of patients with Wolff-Parkinson-White (WPW) syndrome. When the accessory pathways are located close to the coronary sinus or fibrous ring of the tricuspid or mitral valves, the endocardial radiofrequency ablation it is usually used. When patients have an epicardial or intramyocardial accessory pathways, the use of endocardial radiofrequency ablation might be not effective due to the difficult availability of the ablation catheter in the areas of the radiofrequency exposure zone.
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Bockeriа et al. (2020) conducted a review in Wolff-Parkinson-White syndrome. Surgical methods and radiofrequency ablation was evaluated. While radiofrequency ablation is the primary treatment for Wolff-Parkinson-White syndrome, open heart surgery or thoracoscopic approaches remain the methods of choice for eliminating epicardial or intramyocardial accessory pathways.
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