Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist
Introduction. Anteroseptal accessory pathways (APs) are located in the apex of the triangle of Koch’s connecting the atrial and ventricular septum in the region of the His bundle. Ablation of anteroseptal pathway locations remains a challenge to the electrophysiologist due to a very high ri...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Military Health Department, Ministry of Defance, Serbia
2015-01-01
|
| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501504375V.pdf |
| _version_ | 1818273097665478656 |
|---|---|
| author | Vukmirović Mihailo Angelkov Lazar Vukmirović Filip Tomašević-Vukmirović Irena |
| author_facet | Vukmirović Mihailo Angelkov Lazar Vukmirović Filip Tomašević-Vukmirović Irena |
| author_sort | Vukmirović Mihailo |
| collection | DOAJ |
| description | Introduction. Anteroseptal accessory pathways (APs) are located in the apex
of the triangle of Koch’s connecting the atrial and ventricular septum in the
region of the His bundle. Ablation of anteroseptal pathway locations remains
a challenge to the electrophysiologist due to a very high risk of transiet or
permanent atrioventricular (AV) block. Case report. A male, 18-year-old,
patient was hospitalized due to radiofrequency (RF) ablation of APs. He was
an active football player with frequent palpitations during efforts
accompanied by dyspnea and lightheadedness, but without syncope.
Electrocardiography on admission showed intermittent preexcitations.
Intracardiac mapping showed the earliest ventricular activation that preceded
surface electrocardiographic delta wave in anteroseptal region very close to
the AV node and His bundle. Using a long vascular sheath for stabilization of
the catheter tip, RF energy was delivered at the target site starting at very
low energy levels and because of the absence of either PR prolongation, as
well as accelerated junctional rhythm during the first 15 sec, the power was
gradually increased to 40W, so after application RF energy preexcitation was
not registered. Conclusion. Despite this proximity to the His bundle and very
high risk of transiet or permanent AV block anteroseptal APs can still be
ablated successfully. |
| first_indexed | 2024-12-12T21:52:33Z |
| format | Article |
| id | doaj.art-7a00f06a3cdf49eabf6068a8e8454d3c |
| institution | Directory Open Access Journal |
| issn | 0042-8450 |
| language | English |
| last_indexed | 2024-12-12T21:52:33Z |
| publishDate | 2015-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-7a00f06a3cdf49eabf6068a8e8454d3c2022-12-22T00:10:44ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502015-01-0172437537810.2298/VSP1504375V0042-84501504375VRadiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologistVukmirović Mihailo0Angelkov Lazar1Vukmirović Filip2Tomašević-Vukmirović Irena3Clinical Center of Montenegro, Department of Cardiology, Podgorica, MontenegroFaculty of Medicine, Dedinje Cardiovascular Institute, Department of Cardiology, BelgradeClinical Center of Montenegro, Department of Pathology, Podgorica, MontenegroClinical Center of Montenegro, Department of Radiology, Podgorica, MontenegroIntroduction. Anteroseptal accessory pathways (APs) are located in the apex of the triangle of Koch’s connecting the atrial and ventricular septum in the region of the His bundle. Ablation of anteroseptal pathway locations remains a challenge to the electrophysiologist due to a very high risk of transiet or permanent atrioventricular (AV) block. Case report. A male, 18-year-old, patient was hospitalized due to radiofrequency (RF) ablation of APs. He was an active football player with frequent palpitations during efforts accompanied by dyspnea and lightheadedness, but without syncope. Electrocardiography on admission showed intermittent preexcitations. Intracardiac mapping showed the earliest ventricular activation that preceded surface electrocardiographic delta wave in anteroseptal region very close to the AV node and His bundle. Using a long vascular sheath for stabilization of the catheter tip, RF energy was delivered at the target site starting at very low energy levels and because of the absence of either PR prolongation, as well as accelerated junctional rhythm during the first 15 sec, the power was gradually increased to 40W, so after application RF energy preexcitation was not registered. Conclusion. Despite this proximity to the His bundle and very high risk of transiet or permanent AV block anteroseptal APs can still be ablated successfully.http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501504375V.pdfheart conduction systemarrhythmias+ cardiaccatheter ablationtreatment outcome |
| spellingShingle | Vukmirović Mihailo Angelkov Lazar Vukmirović Filip Tomašević-Vukmirović Irena Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist Vojnosanitetski Pregled heart conduction system arrhythmias+ cardiac catheter ablation treatment outcome |
| title | Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist |
| title_full | Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist |
| title_fullStr | Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist |
| title_full_unstemmed | Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist |
| title_short | Radiofrequency ablation of anteroseptal accessory pathway: A challenge to the electrophysiologist |
| title_sort | radiofrequency ablation of anteroseptal accessory pathway a challenge to the electrophysiologist |
| topic | heart conduction system arrhythmias+ cardiac catheter ablation treatment outcome |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501504375V.pdf |
| work_keys_str_mv | AT vukmirovicmihailo radiofrequencyablationofanteroseptalaccessorypathwayachallengetotheelectrophysiologist AT angelkovlazar radiofrequencyablationofanteroseptalaccessorypathwayachallengetotheelectrophysiologist AT vukmirovicfilip radiofrequencyablationofanteroseptalaccessorypathwayachallengetotheelectrophysiologist AT tomasevicvukmirovicirena radiofrequencyablationofanteroseptalaccessorypathwayachallengetotheelectrophysiologist |