Radiofrequency catheter ablation in athletes with wolff-parkinson- white syndrome results era long-term follow-up

Radiofrequency catheter ablation (RCA) has gained wide acceptance as a definitive treatment for supraventricular arrhythmias and is characterized with a high success rate and low morbidity and mortality. The role of this technique in the setting of professional athletes suffering from supraventricular arrhythmias has not been well established. As the use of drugs is not permitted by law in Italy, RCA is the only therapy that allows the symptomatic athlete to go back to performing in competitions. Seven professional athletes (mean age 20±4 yrs) with symptomatic Wolff-Parkinson- White (WPW) syndrome were referred to our Institute from June 1991 and July 1993. The athletes underwent a cardiological protocol including e complete family and clinical history, 24 hour ambulatory monitoring, maximal stress test, 2 D Echo Doppler color flow, transesophageal atrial pacing at rest and during exercise and in two athletes electrophysiological endocavitary study. The presence during sport activity of symptomatic spontaneous paroxismal supraventricular tachyarrhythmias, with antiarrhythmic drug treatment were indications for RCA. In 4 patients the accessory pathway was left lateral and in 3 was right posteroseptal. After an accurate mapping of the site of interest an average of attempts of Radiofrequency (RF) applications were carried out. The immediate success rate of the procedure in the whole group was 100%. No complications were reported. After 3 months, transesophageal electrophysiologic testing and Holter recording were performed in order to evaluate recurrence of conduction along the accessory pathway and inducibility of arrhythmias. No recurrence was detected. All patients took up to sports activity again. During a mean follow up of 26±4 months all patients were still asymptomatic. Thus this study proves the efficiency and the safety of RCA in competitive athletes.