Transferencia de pacientes con trastornos del ritmo cardíaco para ablación con radiofrecuencia y su seguimiento durante cinco años

Introduction: The possibility to locate structures involved in arrhythmias with the use of catheter electrodes gave an impetus to the development of techniques linked to the selective destruction of cardiac tissue. This is possible through radiofrequency catheter ablation. These procedures are the first choice treatment for most cardiac arrhythmias. The objective was to characterize clinically the pre and post therapeutic procedure for patients transferred to receive radiofrequency ablation. Method: A prospective and descriptive study in 26 patients with heart rhythm disorders who were referred for radiofrequency ablation and followed up for five years at the Cardiology Outpatient Department of the Dr. Gustavo Aldereguia Lima Hospital, in Cienfuegos. The variables studied were age, sex, type of clinical arrhythmia, arrhythmogenic substrate ablated, complications, initial success and recurrence of the treated arrhythmia. Results: The mean age of patients was 40.9 ± 17.6 years, mostly women (57.7%). Younger patients (mean age 38.6 ± 19.7 years) were treated for atrioventricular nodal reentrant tachycardia and older patients (mean age 53.4 ± 23 years) underwent a non-selective ablation of the atrioventricular node. Half of the patients had orthodromic tachycardia; therefore, the most commonly treated arrhythmogenic substrate was an accessory pathway (65.4%). There were two major complications (7.7%), none of them directly related to the application of radiofrequency energy. In two patients (9.1%), the previously treated clinical arrhythmia recurred during the first year; both of them had right accessory pathways. Conclusions: It was feasible to transfer patients for radiofrequency ablation because of agreements with two centers which conduct the procedure. Most of them had tachyarrhythmias involving accessory pathways. Only two major complications occurred; the initial success rate was adequate and the recurrence rate of the arrhythmia was small.