Journal Article

Evidence for an incomplete mitral isthmus block after failed ablation of a left postero-inferior concealed accessory pathway

Agustín Bortone, François Brigadeau, Jean Luc Pasquié and Dominique Lacroix

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 8, issue 6, pages 434-437
Published in print June 2006 | ISSN: 1099-5129
Published online May 2006 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eul032
Evidence for an incomplete mitral isthmus block after failed ablation of a left postero-inferior concealed accessory pathway

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We report the case of a young woman in whom previous ablation of a concealed left-sided accessory pathway (AP) created an iatrogenic mitral block. The mitral block was responsible for a split retrograde atrial activation pattern during orthodromic atrioventricular re-entrant tachycardia (AVRT). The differential diagnoses are discussed. The AP was ablated at the site with the shortest interval between the ventricular signal and the earliest component of the retrograde atrial activation. Meticulous mapping is paramount during AVRT with an unusual retrograde atrial activation pattern.

Keywords: Concealed accessory pathway; Split retrograde atrial activation; Mitral isthmus block.

Journal Article.  1785 words.  Illustrated.

Subjects: Cardiovascular Medicine

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