Evolution of ablation techniques: From WPW to complex arrhythmias

Abstract

Radiofrequency ablation of cardiac arrhythmias has come to widespread use since it was first performed in the mid-1980s. Together with an increasing understanding of arrhythmia mechanisms both at the atrial and ventricular levels, technology has made tremendous progress. With improvements in catheter materials and function, development of different energy sources, and the advance of mapping techniques, catheter ablation can nowadays be used to cure all types of arrhythmia including focally induced atrial and ventricular fibrillation. With the most recent innovations in the integration of mapping and cardiac imaging, robotic and magnetic navigation, success rates and safety of catheter ablation have greatly increased. Catheter ablation has become not only an alternative to drug therapy in the treatment of supraventricular arrhythmias, but is nowadays in many cases the first therapeutic choice. In the future, the reduction of radiation exposure by using non-fluoroscopic imaging and robotic navigation will further advance this curative approach. © The European Society of Cardiology 2007. All rights reserved.