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Atrial double potentials associated with a left-sided accessory pathway having a single ventricular and two remote
J Hluchy1, D Lautermann, G V Sabin
1Department of Cardiology and Angiology, Elisabeth Hospital, Essen, Germany.
Clinical Cardiology
|March 1, 1997
Summary
This case study details a complex Wolff-Parkinson-White syndrome case in a 63-year-old female. Successful ablation of a unique left-sided accessory pathway resolved atrial fibrillation and double potentials.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Case Reports
Background:
- Wolff-Parkinson-White syndrome is characterized by accessory pathways causing supraventricular tachycardias.
- Atrial fibrillation in WPW can be life-threatening due to rapid ventricular rates.
- Electrophysiologic study (EPS) and radiofrequency ablation are standard treatments.
Observation:
- A 63-year-old female patient presented with atrial fibrillation and Wolff-Parkinson-White syndrome.
- Shortest pre-excited RR interval was 160 ms, indicating significant preexcitation.
- Detailed EPS revealed a complex left-sided accessory pathway with dual atrial insertions and a narrow ventricular isthmus.
Findings:
- The complex accessory pathway exhibited atrial double potentials recorded from the coronary sinus.
- Temperature-guided radiofrequency ablation was performed.
- Complete elimination of accessory pathway conduction was achieved with ablation at the left lateral ventricular aspect.
Implications:
- This case highlights the successful management of a rare, complex accessory pathway in WPW.
- The findings suggest that targeted ablation can effectively treat complex accessory pathways and associated arrhythmias.
- This approach offers a potential solution for patients with challenging WPW anatomies.