AIMS: To evaluate the long-term clinical results of patients who underwent successful radiofrequency catheter ablation of a symptomatic drug-resistant accessory-pathway-mediated tachycardia. METHODS AND RESULTS: Clinical follow-up was done by direct contact with the patients and their physicians. One hundred and eighty consecutive patients (113 males, 67 females) were followed during a median period of 48.1 months. There were seven procedure related complications (4%). During the follow-up period, 79% of the patients remained asymptomatic; 14% complained of short bouts of palpitations due to isolated or short runs of atrial or ventricular premature beats; 7% had sustained palpitations due either to accessory pathway recurrence (4%) or supraventricular tachyarrhythmias not associated with an accessory pathway (3%). Symptoms due to accessory pathway recurrence appeared either in the first month following the ablation or at least later than 3 months when sustained supraventricular arrhythmias occurred related to another cause. CONCLUSIONS: Initially successful radiofrequency catheter ablation has a low, long-term recurrence rate (4%). Recurrence of accessory-pathway-mediated tachycardia is observed during the first month while later symptoms suggest supraventricular arrhythmias from another cause.