Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping

Chen, Ming Long; Yang, Bing; Ju, Wei Zhu; Chen, Hong Wu; Chen, Chun; Hou, Xiao Feng; Zhang, Fengxiang; Cui, Jun You; Zhang, Chuan Huan; Shan, Qijun; Zou, Jian Gang; Sun, Jiaguang; Xi, Yu Tao; Cheng, Jie; Cao, Ke

doi:10.1111/j.1540-8167.2010.01857.x

Cited by 28 publications

(17 citation statements)

References 23 publications

(63 reference statements)

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“…There are several reasons for the lower success rate. In contrast to the mitral annulus, the tricuspid ring is larger and less complete which allows APs to bridge these gaps . Catheter stability, especially at the superior part of the tricuspid ring valve, might be difficult to achieve.…”

Section: Introductionmentioning

confidence: 99%

Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

Telishevska

Faelchle

Buiatti

et al. 2017

Pacing Clinical Electrophis

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Section: Introductionmentioning

confidence: 99%

Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

Telishevska

Faelchle

Buiatti

et al. 2017

Pacing Clinical Electrophis

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“…The X-ray exposure time was lower in the group that concomitantly used EAM 13 . A group of 11 patients with accessory bundles on the right lateral wall who underwent unsuccessful ablation fluoroscopy then underwent a new EAM procedure, which was successful in each case 14 . Nine pregnant patients with supraventricular tachycardias that were not controlled through medication were ablated using EAM and minimal fluoroscopy time; the patients did not have recurrences following the procedure 15 .…”

Section: Discussionmentioning

confidence: 99%

Catheter Ablation of Arrhythmias Exclusively Using Electroanatomic Mapping: A Series of Cases

Pires¹,

Leiria²,

Kruse³

et al. 2013

Arquivos Brasileiros De Cardiologia

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BackgroundCatheter ablation is a treatment that can cure various cardiac arrhythmias. Fluoroscopy is used to locate and direct catheters to areas that cause arrhythmias. However, fluoroscopy has several risks. Electroanatomic mapping (EAM) facilitates three-dimensional imaging without X-rays, which reduces risks associated with fluoroscopy. ObjectiveWe describe a series of patient cases wherein cardiac arrhythmia ablation was exclusively performed using EAM. MethodsPatients who presented with cardiac arrhythmias that were unresponsive to pharmacological therapy were prospectively selected between March 2011 and March 2012 for arrhythmia ablation exclusively through EAM. Patients with indications for a diagnostic electrophysiology study and ablation of atrial fibrillation, left atrial tachyarrhythmias as well as hemodynamically unstable ventricular arrhythmia were excluded. We documented the procedure time, success rate and complications as well as whether fluoroscopy was necessary during the procedure. ResultsIn total, 11 patients were enrolled in the study, including seven female patients (63%). The mean age of the patients was 50 years (SD ±16.5). Indications for the investigated procedures included four cases (35%) of atrial flutter, three cases (27%) of pre-excitation syndrome, two cases (19%) of paroxysmal supraventricular tachycardia and two cases (19%) of ventricular extrasystoles. The mean procedure duration was 86.6 min (SD ± 26 min). Immediate success (at discharge) of the procedure was evident for nine patients (81%). There were no complications during the procedures. ConclusionThis study demonstrates the feasibility of performing an arrhythmia ablation exclusively using EAM with satisfactory results.

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“…This case demonstrates that in patients with a left‐side AP, which is difficult to ablate because of a possible epicardial course, an approach targeting the atrial insertion site can be successful. This technique is analogous to that described for patients with failed right‐side ablations due to probable epicardial APs 10 . Since epicardial pathways on the left side can often be mapped and ablated by placing the ablation catheter in the coronary sinus or the aortic cusps, this approach may not be needed often 11,12 .…”

Section: Discussionmentioning

confidence: 99%

“…This technique is analogous to that described for patients with failed right-side ablations due to probable epicardial APs. 10 Since epicardial pathways on the left side can often be mapped and ablated by placing the ablation catheter in the coronary sinus or the aortic cusps, this approach may not be needed often. 11,12 However, in those cases where the standard mapping and ablation techniques are not effective, access to the aortic cusps or coronary sinus is limited or these locations pose an unacceptable risk because of close proximity to a coronary artery using this alternative approach may be a viable option.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Permanent Junctional Reciprocating Tachycardia Ablated on the Roof of the Left Atrium

Kalbfleisch

Rhodes

2012

Cardiovasc electrophysiol

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Left-sided anteroseptal accessory pathways that course through the aortomitral fibrous continuity are some of the rarest types of accessory pathways. At this region the atrium and ventricle are separated by their greatest distance because of the intervening aortic valve. These pathways often have a long circuitous course that may involve the root and cusps of the aortic valve. Prior reports have demonstrated the feasibility of ablating these pathways along the anteroseptal mitral annulus, the left ventricular outflow tract, or in the left or noncoronary cusps of the aortic valve. We describe a case of a concealed decremental anteroseptal accessory pathway that was ablated on the roof of the left atrium remote from the mitral or aortic valve annuli. This report indicates that when an appropriate site for ablation of a left-sided anteroseptal accessory pathway is not found close to a valve annulus, these pathways may be amenable to ablation by targeting their atrial insertion site.

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Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping

Cited by 28 publications

References 23 publications

Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

Irrigated‐tip catheters for radiofrequency ablation of right‐sided accessory pathways in adolescents

Catheter Ablation of Arrhythmias Exclusively Using Electroanatomic Mapping: A Series of Cases

A Rare Case of Permanent Junctional Reciprocating Tachycardia Ablated on the Roof of the Left Atrium

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