Simultaneous Accessory Pathway and AV Node Mechanical Block
We report a clinical case of a 22-year-old female referred to our institution due to palpitations and preexcitation. Her ECG suggested a right superior paraseptal accessory pathway (AP), which was localised during the electrophysiological study at the superior paraseptal region in close proximity to...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2013-09-01
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| Series: | Indian Pacing and Electrophysiology Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0972629216306726 |
| _version_ | 1818930101296824320 |
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| author | Daniel Garofalo, MD, FRACP Alfonso Gomez Gallanti, MD David Filgueiras Rama, MD Rafael Peinado Peinado, PhD, FESC |
| author_facet | Daniel Garofalo, MD, FRACP Alfonso Gomez Gallanti, MD David Filgueiras Rama, MD Rafael Peinado Peinado, PhD, FESC |
| author_sort | Daniel Garofalo, MD, FRACP |
| collection | DOAJ |
| description | We report a clinical case of a 22-year-old female referred to our institution due to palpitations and preexcitation. Her ECG suggested a right superior paraseptal accessory pathway (AP), which was localised during the electrophysiological study at the superior paraseptal region in close proximity to the His recordings. Reproducible orthodromic reciprocating tachycardia was induced by atrial pacing with extrastimuli. Cryo-mapping performed in the area of earliest atrial activation was not able to terminate the tachycardia. A second attempt, slightly more posterior, caused mechanical block of the AP, which rendered the tachycardia non-inducible. More pressure with the ablation catheter determined a Wenckebach type supra-hisian AV block, which was transient but reproducible. Given this finding no ablation was done. Simultaneous block to the AP and the atrioventricular node has rarely been reported using radiofrequency energy. However, to our knowledge this phenomenon has not been previously reported in large series using cryo-thermal energy. |
| first_indexed | 2024-12-20T03:55:20Z |
| format | Article |
| id | doaj.art-d0f87e1c920748ceb3ba0f269ec02215 |
| institution | Directory Open Access Journal |
| issn | 0972-6292 |
| language | English |
| last_indexed | 2024-12-20T03:55:20Z |
| publishDate | 2013-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Pacing and Electrophysiology Journal |
| spelling | doaj.art-d0f87e1c920748ceb3ba0f269ec022152022-12-21T19:54:20ZengElsevierIndian Pacing and Electrophysiology Journal0972-62922013-09-0113518518910.1016/S0972-6292(16)30672-6Simultaneous Accessory Pathway and AV Node Mechanical BlockDaniel Garofalo, MD, FRACPAlfonso Gomez Gallanti, MDDavid Filgueiras Rama, MDRafael Peinado Peinado, PhD, FESCWe report a clinical case of a 22-year-old female referred to our institution due to palpitations and preexcitation. Her ECG suggested a right superior paraseptal accessory pathway (AP), which was localised during the electrophysiological study at the superior paraseptal region in close proximity to the His recordings. Reproducible orthodromic reciprocating tachycardia was induced by atrial pacing with extrastimuli. Cryo-mapping performed in the area of earliest atrial activation was not able to terminate the tachycardia. A second attempt, slightly more posterior, caused mechanical block of the AP, which rendered the tachycardia non-inducible. More pressure with the ablation catheter determined a Wenckebach type supra-hisian AV block, which was transient but reproducible. Given this finding no ablation was done. Simultaneous block to the AP and the atrioventricular node has rarely been reported using radiofrequency energy. However, to our knowledge this phenomenon has not been previously reported in large series using cryo-thermal energy.http://www.sciencedirect.com/science/article/pii/S0972629216306726Orthodromic reciprocating tachycardiaAccessory pathwayCryoablationAtrioventricular nodeBlock |
| spellingShingle | Daniel Garofalo, MD, FRACP Alfonso Gomez Gallanti, MD David Filgueiras Rama, MD Rafael Peinado Peinado, PhD, FESC Simultaneous Accessory Pathway and AV Node Mechanical Block Indian Pacing and Electrophysiology Journal Orthodromic reciprocating tachycardia Accessory pathway Cryoablation Atrioventricular node Block |
| title | Simultaneous Accessory Pathway and AV Node Mechanical Block |
| title_full | Simultaneous Accessory Pathway and AV Node Mechanical Block |
| title_fullStr | Simultaneous Accessory Pathway and AV Node Mechanical Block |
| title_full_unstemmed | Simultaneous Accessory Pathway and AV Node Mechanical Block |
| title_short | Simultaneous Accessory Pathway and AV Node Mechanical Block |
| title_sort | simultaneous accessory pathway and av node mechanical block |
| topic | Orthodromic reciprocating tachycardia Accessory pathway Cryoablation Atrioventricular node Block |
| url | http://www.sciencedirect.com/science/article/pii/S0972629216306726 |
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