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Localization and radiofrequency ablation of atriofascicular pathways using electroanatomic mapping
Hakan Paydak1, Priscilla Piros, Melvin M Scheinman
1Departments of Pediatrics and Internal Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA.
Journal of Electrocardiology
|May 24, 2003
Summary
Atriofascicular pathways, uncommon causes of tachycardia, were successfully mapped and ablated using electroanatomic mapping. This technique precisely targets the ventricular insertion, offering a less invasive approach for ablation of these challenging pathways.
Area of Science:
- Electrophysiology
- Cardiology
Background:
- Atriofascicular pathways can support antidromic reentrant tachycardia, presenting a challenge for ablation due to their uncommon nature and potential for conduction loss with traditional mapping.
- These pathways may insert into the right bundle branch, leading to initial right ventricular activation distinct from other accessory pathways.
Observation:
- Electroanatomic mapping was employed in two patients to precisely delineate the ventricular insertion of atriofascicular pathways.
- During sinus rhythm and atrial pacing, specific atriofascicular potentials were identified and tagged below the tricuspid valve annulus.
Findings:
- The study successfully mapped and ablated the ventricular insertion of atriofascicular pathways in two cases.
- A single radiofrequency lesion at the tagged site was sufficient for successful ablation in both patients.
Implications:
- Electroanatomic mapping of the right ventricle provides an effective method for localizing and ablating atriofascicular pathways.
- This approach may reduce the risk of iatrogenic conduction abnormalities associated with traditional mapping techniques.