Previous studies have reported only short-term (6 to 10 months) follow-up after ablation of atrioventricular (AV) nodal reentrant tachycardia by using the anterior approach. The objective of this study was to determine the long-term efficacy and safety of radiofrequency catheter ablation of AV nodal reentrant tachycardia with the anterior-approach method. In 56 patients (16 men and 40 women; mean [+/-SD] age, 44 +/- 19 years) with symptomatic AV nodal reentrant tachycardia. In 53 patients, ablation was performed initially by using a standard 7F, 2 mm-tipped tripolar His bundle catheter when the large-tip electrode was not as available, and in the remaining 3 patients, ablation was performed with a 7F, 4 mm-tipped catheter. Ablation was successful in the short term in 53 (95%) patients after a median of 7 radiofrequency applications. Three (5%) patients developed complete AV block immediately after ablation. Six (11 %) patients had recurrence of tachycardia within 3 months (n = 5) and 13 months (n = 1) after ablation. Repeated ablation resulted in successful outcome in 4 patients and in complete AV block in 1 patient; the other patient refused a repeated ablation attempt. A total of 51 patients was monitored for 36 +/- 12 months (range, 25 to 72 months), and none had tachycardia recurrence or delayed AV block. In conclusion, our results show that the anterior approach to radiofrequency catheter ablation can be used successfully to treat patients with AV nodal reentrant tachycardia with a good long-term efficacy and safety.