Journal Article

Catheter ablation of anteroseptal accessory pathway in the non-coronary aortic sinus

He Huang, Xingxiang Wang, Feifan Ouyang and Matthias Antz

in EP Europace

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

Volume 8, issue 12, pages 1041-1044
Published in print December 2006 | ISSN: 1099-5129
Published online November 2006 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eul122
Catheter ablation of anteroseptal accessory pathway in the non-coronary aortic sinus

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We report a patient with atrioventricular reentrant tachycardia (AVRT) with bidirectional conduction over an anteroseptal accessory pathway (AP) who underwent successful ablation in the non-coronary aortic sinus (AS). In three previous attempts, the intracardiac recordings showed an anteroseptal AP with antegrade and retrograde conduction that failed to be ablated in spite of radiofrequency (RF) applications from the right and left anteroseptal regions. During the study, the earliest atrial activation during tachycardia was recorded in the non-coronary AS preceding the atrial activation at the His bundle (HB) region by 24 ms, and the anteroseptal AP was successfully blocked by one single ablation in the non-coronary AS. These data strongly suggest that careful mapping of an anteroseptal AP in the non-coronary AS may provide an alternative ablation approach in patients with previously failed ablation.

Keywords: Atrioventricular reentrant tachycardia; Accessory pathway; Catheter ablation; Aorta; Sinus of Valsalva

Journal Article.  1750 words.  Illustrated.

Subjects: Cardiovascular Medicine

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