Catheter Ablation of Accessory Atrioventricular Pathways (Wolff–Parkinson–White Syndrome) by Radiofrequency Current

FOR more than 20 years, surgical ablation of the accessory pathway has served as definitive therapy for patients with the Wolff—Parkinson—White syndrome. 1 2 3 The successful introduction of percutaneous catheter ablation of the atrioventricular junction in 1982 4 , 5 stimulated interest in nonsurgical ablation of accessory atrioventricular pathways. 6 7 8 9 10 11 Initial approaches used, with moderate success, high-energy direct-current shocks delivered near the coronary-sinus ostium to ablate posteroseptal pathways 12 13 14 and to the endocardial surface of the tricuspid annulus to ablate right—free-wall pathways. 15 16 17 High-energy shocks were also applied, with very limited success, within the coronary sinus to ablate left—free-wall accessory pathways. 18 Warin and coworkers successfully ablated 94 percent . . .