Comparison of catheter ablation using direct current energy versus radiofrequency: observations in 147 patients with supraventricular tachyarrhythmias.

We studied the follow-up of 147 patients who underwent catheter ablation because of drug resistant supraventricular tachyarrhythmias. Direct current (DC) ablation was performed in 116 patients, while 31 patients underwent radiofrequency (RF) ablation. In 101 patients (87%) with DC ablation and in 28 patients (90%) with RF ablation, complete atrioventricular (AV) block was achieved initially. Fifteen patients (13%) with DC ablation and three patients (11%) with RF ablation resumed AV conduction. Serious complications occurred in eight patients (7%) with DC ablation and in none of the patients with RF ablation. During the mean follow-up of 45 +/- 24 months, 13 patients died (11%) who underwent DC ablation; during the mean follow-up of 11 plus or minus 3 months, no patient died who had had RF ablation. Transcatheter ablation using DC or RF is an effective treatment in patients with drug resistant supraventricular arrhythmias, providing a beneficial long-term outcome including an improved quality of life. Although the risk of complications is low, this procedure should be reserved for patients with supraventricular arrhythmias who do not respond to conventional drug therapy.