What is a typical long-term outcome after catheter ablation of an accessory pathway in WPW–mediated tachycardias?

• A. A cure of tachyarrhythmia with a low likelihood of recurrence.
• B. Requires ongoing daily antiarrhythmic medication.
• C. Usually worsens conduction in the AV node.
• D. Has no impact on future tachyarrhythmias.

Answer: (A)

Removing the accessory pathway eliminates the substrate for WPW-related tachycardias, so the abnormal circuit can no longer form. When ablation is successful, the tachyarrhythmia is no longer inducible, and most patients remain free of WPW tachycardias in the long term. Durability is high in experienced centers, with only a small chance of late recurrence due to reconnection or the presence of an additional pathway. After a successful procedure, antiarrhythmic drugs are usually not needed, and AV nodal conduction is preserved; a rare complication is AV block when the ablation is very near the AV node, but this does not define the typical outcome. In short, catheter ablation commonly cures the tachyarrhythmia and markedly lowers the risk of future WPW-related episodes.