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Left lateral accessory pathway successfully ablated from within the coronary sinus, a case report
1Franciscan Hospital 3500 Franciscan Way, Michigan City, IN 46360, USA.
American Journal of Cardiovascular Disease
|May 22, 2023
Summary
Wolff-Parkinson-White (WPW) syndrome, a heart condition, is often treated with radiofrequency ablation. This case report details successful ablation of a difficult accessory pathway from the coronary sinus when endocardial ablation failed.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Case Reports
Background:
- Wolff-Parkinson-White (WPW) syndrome involves congenital accessory electrical pathways causing supraventricular tachycardia.
- Radiofrequency ablation is a primary curative treatment for WPW syndrome, with a high success rate.
- Epicardial proximity of accessory pathways can complicate endocardial ablation attempts.
Observation:
- A patient presented with a left lateral accessory pathway resistant to standard endocardial ablation.
- Multiple ablation attempts targeting pathway potentials from the endocardium were unsuccessful.
- The accessory pathway was located near the epicardium, posing a challenge for conventional treatment.
Findings:
- Successful ablation of the left lateral accessory pathway was achieved.
- The ablation was performed from within the distal coronary sinus, an epicardial approach.
- This strategy overcame the limitations of endocardial ablation in this challenging case.
Implications:
- Epicardial ablation via the coronary sinus offers a viable alternative for refractory WPW syndrome cases.
- This approach expands treatment options for patients with accessory pathways resistant to standard therapy.
- Successful epicardial ablation can improve outcomes and reduce tachycardia episodes in complex WPW syndrome patients.
