Successful ablation of right atriofascicular pathway guided by pathway potential recording despite catheter-induced...

Radiofrequency ablation of right atriofascicular pathways (RAFPs) is frequently complicated by the occurrence of mechanically induced trauma to the pathway by the ablation catheter. Since recording of accessory pathway (AP) potential is critical for achieving successful ablation of RAFP, one may fear that long-lasting mechanically induced trauma to the AP will affect recording of AP potential and thereby adversely affect the procedure outcome. We report a patient with antidromic tachycardia involving an antegrade RAFP. Despite long-lasting catheter trauma to the RAFP, mapping of the tricuspid annulus showed persistent recording of an AP potential that enabled us to continue the procedure and successfully abolish the AP.