Objective—To determine preoperatively, by analysing asynchronous left ventricular wall motion, whether to approach through the right ventricle or the left ventricle when carrying out catheter ablation of the accessory pathway in WolVParkinson-White syndrome, especially in patients with the pathway located on the septum. Methods—73 patients with manifest WolV-Parkinson-White syndrome who underwe...

During the electrophysiologic study of 435 patients referred for evaluation of Wolff-Parkinson-White syndrome, 42 (10%) had preexcited reciprocating tachycardia (defined as a macro-reentrant tachycardia that used an accessory atrioventricular [AV] pathway for antegrade conduction). The ages of the patients ranged from 9 to 67 years (27 +/- 14). Thirty-three were male patients, nine female, and ...

We report a 26-year-old woman with frequent episodes of palpitation and dizziness. Resting electrocardiography showed no evidence of ventricular preexcitation. During electrophysiologic study, a concealed right posteroseptal accessory pathway was detected and orthodromic atrioventricular reentrant tachycardia incorporating this pathway as a retrograde limb was reproducibly induced. After succes...

An electrophysiological study was performed on a 39-year-old woman with recurrent palpitations. She initially presented in 1985 with atrial fibrillation, ventricular preexcitation, and a rapid ventricular response. At that time, she underwent open heart surgery, and mapping demonstrated multiple posteroseptal and left free wall accessory pathways. Accessory pathway conduction was abolished surg...

BACKGROUND Rapid anterograde conduction in the setting of ventricular preexcitation is associated with an increased risk of sudden cardiac death. The effect of isoproterenol in this setting is unclear, particularly in younger anesthetized patients. The aim of this study was to determine the effect of isoproterenol on accessory-pathway conduction in children undergoing general anesthesia and its...

Catheter ablation of Wolff-Parkinson-White syndrome is associated with up to 5% of failure. Coronary sinus (CS) abnormalities or connections between CS myocardial coat and left ventricular epicardium are associated with posteroseptal and left posterior accessory pathways (AP). A 41-year-old patient with WPW syndrome was referred to our hospital after three unsuccessful ablations. The 12-lead EC...

WPW syndrome is a rare congenital heart disease due to an accessory pathway between the atrium and the ventricle. Its ECG pattern is characterized by a short PR interval, a delta wave, a wide QRS complex and an abnormal ventricular repolarisation. Patients are usually asymptomatic, or have frequent paroxysmal episodes of tachycardia. These tachycardias are supraventricular tachycardias related ...

His bundle ablation was performed in a 48 year old man with drug refractory orthodromic atrioventricular reentrant tachycardia and paroxysmal atrial fibrillation. Reentry was caused by a left free wall concealed accessory pathway. Interruption of the His bundle by low energy direct current shock (25 J) was quickly followed by anterograde conduction via the accessory pathway, with various forms ...

BACKGROUND AND OBJECTIVES The earliest atrial (A)/ventricular (V) activation potential, or accessory pathway (AP) potential are commonly used as ablation targets for atrioventricular (AV) APs. However, these targets are sometimes ambiguous. SUBJECTS AND METHODS We reviewed 119 catheter ablation cases in 112 patients diagnosed with orthodromic atrioventricular reentrant tachycardia (AVRT) or W...

OBJECTIVE To evaluate characteristics of patients and accessory pathways as well as additional technical factors involved in the reappearance of accessory pathway conduction after successful ablation. DESIGN Analysis of recurrences after radiofrequency ablation. SETTING 163 consecutive patients with 167 accessory pathways. SUBJECTS 97 men and 66 women with a mean (SD) age of 36 (14) range...