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Related Experiment Videos

Atriofascicular pathways: Where to ablate?

Snehal Kothari1, Anoop K Gupta, Yash Y Lokhandwala

  • 1KEM Hospital, Mumbai, India.

Pacing and Clinical Electrophysiology : PACE
|November 15, 2006
PubMed
Summary
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Radiofrequency ablation (RFA) successfully treated atriofascicular accessory pathways (APs) in 97% of patients. Ablation at the ventricular insertion site, necessary in 48% of cases, often caused right bundle branch block (RBBB).

Area of Science:

  • Electrophysiology
  • Cardiology
  • Medical Devices

Background:

  • Atriofascicular accessory pathways (APs), or Mahaim pathways, are uncommon causes of preexcitation.
  • Standard ablation targets high-frequency potentials on the tricuspid annulus (TA).
  • This study details mapping and ablation experiences in 29 patients with atriofascicular APs.

Purpose of the Study:

  • To analyze the outcomes of radiofrequency ablation (RFA) for atriofascicular accessory pathways.
  • To evaluate the efficacy and safety of targeting different ablation sites.
  • To identify potential complications associated with the procedure.

Main Methods:

  • Retrospective analysis of 29 consecutive patients undergoing RFA for atriofascicular APs.
  • Mapping focused on identifying high-frequency potentials along the tricuspid annulus (TA) or at the ventricular insertion site.

Related Experiment Videos

  • Data collected included patient demographics, tachycardia characteristics, ablation site, success rates, and complications.

    • Main Results:

    • Radiofrequency ablation (RFA) achieved a 97% success rate (28/29 patients), with two requiring repeat procedures.
    • A high-frequency potential on the TA was identified in only 52% (15/29) of patients.
    • In 48% (14/29) of patients, ablation targeted the ventricular insertion site, resulting in right bundle branch block (RBBB) in 57% (8/14) of these cases.

    Conclusions:

    • High-frequency potentials on the tricuspid annulus (TA) are not consistently found in atriofascicular pathways.
    • Ablation at the ventricular insertion site is an effective alternative but carries a significant risk of right bundle branch block (RBBB).
    • Despite potential complications like RBBB, radiofrequency ablation remains a successful treatment for atriofascicular accessory pathways.