EARLY EXPERIENCE WITH CARDIAC ELECTROPHSIOLOGY STUDY AND RADIOFREQUENCY ABLATION IN PESHAWAR

Objective: The aim of this study was to evaluate the success and efficacy of electrophysiological study (EPS) and radio frequency ablation (RFA) in Peshawar. Methodology: It was a hospital based prospective study, conducted at cardiology department of HMC and EP Lab of LRH, Peshawar from September 2006 to December 2012. All adult patients with documented tachycardia and any one of following symptoms, palpitation, pre-syncope/near syncope, syncope, drop attack and dyspnea related to arrhythmias were included. EPS and radiofrequency success and complications were recorded. Statistical analysis was performed using SPSS version. 15.0. Results: During this period, 570 patients underwent EPS. The mean age was 37.34 +/- 11years (20-82 years), 90% of the patients were in reproductive age group (20-50 years), male were 51%. All the patients were symptomatic and most common symptom was paroxysmal palpitation, reported in 470 (82%) cases. Twenty nine (4.8%) patients have life threatening arrhythmias. EPS revealed accurate mechanism of arrhythmia and localized the focus and pathways in 550 (96.5%) and RFA carried out in all those patients. Inter-atrial puncture was done in 120 (21%) patients, for ablation of left sided pathways. The overall success of RFA was in 95%. No death and no major complication documented related to the procedure. Self limiting RBBB in 1 patient and minor bleeding in 20 (4.3%) were immediate complications. Exposure to radiation in all patients, DVT in 5 (0.8%) and recurrence of symptoms in 6 (1%) were the late complications. Conclusion: The EPS and RFA is a useful procedure with less morbidity and no mortality.