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Evidence for an incomplete mitral isthmus block after failed ablation of a left postero-inferior concealed accessory
Agustín Bortone1, François Brigadeau, Jean Luc Pasquié
1Service de Cardiologie A, Centre Hospitalo-Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. a-bortone@chu-montpellier.fr
Abstract:
We report the case of a young woman in whom previous ablation of a concealed left-sided accessory pathway (AP) created an iatrogenic mitral block. The mitral block was responsible for a split retrograde atrial activation pattern during orthodromic atrioventricular re-entrant tachycardia (AVRT). The differential diagnoses are discussed. The AP was ablated at the site with the shortest interval between the ventricular signal and the earliest component of the retrograde atrial activation. Meticulous mapping is paramount during AVRT with an unusual retrograde atrial activation pattern.
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