Radiofrequency Catheter Ablation of Parahisian Accessory Pathway

Abstract

introductionPalpitation is a common symptom of Wolf-Parkinson White (WPW) syndrome. The presence of an accessory pathway (AP) contributes to the occurrence of episodes of atrioventricular (AV) re-entrant tachycardias, usually via the orthodromic type of re-entry mechanism. 1,2 In the general population, the prevalence of accessory pathway is 0.15% to 0.25%. 3,4 In pre-excitation syndromes radiofrequency (RF) catheter ablation is nowadays the routine treatment for AP-facilitated tachycardias. 5 Accessory pathways may be located close to the His bundle and the AV node, in the anteroseptal, midseptal, and parahisian regions. The ablation of these pathways is associated with a high risk of complete heart block, due to its proximity to the atrioventricular node. 2,[6][7][8][9] In this case report, we describe the case of a patient with intermittent preexcitation syndrome, caused by a parahisian accessory pathway. case reportA 32 year-old man, a professional driver, presented to our hospital with recurrent palpitations with sudden onset and termination, and two unregistered presyn- Radiofrequency Catheter ABSTRACTRadiofrequency catheter ablation of parahisian accessory pathways in pre-excitation syndrome is a challenging task, due to the extremely high risk of complete atrioventricular block. In this brief report we describe the case of a 32 year-old man presenting a parahisian accessory pathway, who has been successfully treated by radiofrequency ablation. Radiofrequency catheter ablation using low-power radiofrequency current is considered to be the most appropiate method of ablation in adult patients.