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Related Experiment Videos

Accessory pathway automaticity after radiofrequency ablation.

Laurent Macle1, Dipen C Shah, Pierre Jaïs

  • 1Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. lmacle@hotmail.com

Journal of Cardiovascular Electrophysiology
|April 11, 2002
PubMed
Summary
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Radiofrequency ablation successfully treated a concealed accessory pathway by targeting the great cardiac vein. Dissociated electrical activity after ablation suggests automatic accessory pathway activity, a novel finding in electrophysiology.

Area of Science:

  • Electrophysiology
  • Cardiac Electrophysiology
  • Interventional Cardiology

Background:

  • Accessory pathways can cause supraventricular tachycardia.
  • Concealed accessory pathways are challenging to map and ablate.
  • Radiofrequency ablation is a standard treatment for accessory pathways.

Observation:

  • Mapping identified the shortest VA conduction time in the great cardiac vein for a left-sided concealed accessory pathway.
  • Epicardial radiofrequency ablation was performed at this site.
  • Post-ablation, dissociated electrical activity was observed on the ablation catheter during various pacing modes.

Findings:

  • Successful ablation of the accessory pathway was achieved.
  • The dissociated potential, independent of atrial and ventricular activity, suggests automatic accessory pathway activity.

Related Experiment Videos

  • Intermittent conduction block at the ventricular interface was noted.

    • Implications:

    • This case provides evidence for automatic accessory pathway activity.
    • Targeting the great cardiac vein may be a viable strategy for specific accessory pathways.
    • Understanding accessory pathway physiology can improve ablation outcomes.