Dear Sir, Accessory nipples are solitary or multiple rudimentary nipples developing along the two vertical ‘milk-lines’. Most cases are sporadic and asymptomatic. Accessory nipple occurs in 1-6% of the population and affects both genders equally.1 It is often mistaken as dermatofi broma in clinical or dermatoscopic examination. Blum et al. have reported a case of accessory nipple indistinguisha...

INTRODUCTION AND OBJECTIVES The development of ablation techniques for supraventricular arrhythmias in patients with Ebstein's anomaly have led to a need for better understanding of the morphology of the triangle of Koch and the position of the atrioventricular (AV) node in this structure. METHODS The study involved 17 human hearts: 11 with Ebstein's anomaly (age range: 37 weeks' gestation to...

Introduction During orthodromic atrioventricular reentrant tachycardia (AVRT), ventricles are activated anterogradely through the atrioventricular node and retrogradely through an accessory pathway (AP). Antiarrhythmic drugs are initially used to prevent recurrences of AVRT, whereas catheter ablation is frequently performed as a definitive treatment. Occasionally, catheter ablation can be “proa...

Data regarding catheter ablation of anteroseptal accessory pathways through the aortic cusps are limited. We describe two cases of true para-Hisian accessory pathways successfully ablated from the aortic cusps (right coronary cusp and non-coronary cusp, respectively) along with a review of the current literature. Due to the close proximity to the atrioventricular node and the high risk of compl...

A 41-year-old male was presented with drug-resistant supraventricular tachycardia. Electrophysiological study confirmed that the supraventricular tachycardia was caused by dual atrioventricular nodal pathways and a left lateral accessory pathway (AP). The left lateral AP was resistant to traditional endocardial ablation, but was successfully eliminated by radiofrequency ablation via the intraco...

Introduction Atrioventricular nodal reentrant tachycardia (AVNRT) is the second most frequent form of paroxysmal narrow complex tachycardia in the pediatric population. A conservative approach is used for ablation in children because of anatomical limitations and risks related to a permanent pacemaker in the case of atrioventricular nodal conduction damage. Cryoablation has emerged in the first...

An electrophysiological study was performed in a 61 year old man with Wolff- Parkinson-White (WPW) syndrome. At baseline, neither ventricular nor supraventricular tachycardias could be induced. During isoprenaline infusion, ventricular tachycardia originating from the right ventricular outflow tract (RVOT) with a cycle length of 280 ms was induced and subsequently atrioventricular reentrant tac...

A case presenting with AV nodal escape rhythms after obvious sinus depression is described. The escape rhythms arise from two dissociated AV nodal pacemakers with differential physiological properties. Variation in the rate of the upper AV nodal pacemaker results in a form of escape-capture bigeminy. Temporary acceleration of the sinus rhythm results in dissociation between sinus and lower AV n...

• The nature of the system responsible for transmission of excitation from atria to ventricles of the mammalian heart has been a recurrent problem in pl^siology. In 1910 Erlanger demonstrated conclusively that the only normal functional connection between these chambers is the specialized tissue of the bundle of His. However, anatomical evidence showing the occasional presence of other connecti...

We present an interesting image showing sequential loss of anterograde, and subsequently, retrograde conduction during radiofrequency ablation of an accessory pathway. We discuss the possible mechanisms and prior literature concerning this interesting finding.