Successful ablation of a right epicardial accessory pathway via the right ventricular diverticulum in a patient with Wolff-Parkinson-White syndrome.
Wolff-Parkinson-White syndrome
arrhythmias
catheter ablation
epicardial accessory pathway
supraventricular tachycardia (SVT)
ventricular diverticulum
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
21
03
2023
accepted:
28
03
2023
medline:
22
5
2023
pubmed:
2
4
2023
entrez:
1
4
2023
Statut:
ppublish
Résumé
We describe one rare case of successful ablation of a right epicardial accessory pathway (AP) via the right ventricular diverticulum in a patient with Wolff-Parkinson-White syndrome. A 42-year-old woman was referred to the hospital for a catheter ablation of Wolf-Parkinson-White syndrome. The earliest activation was shown to be present in the region of the tricuspid annulus. However, ablation had no effect on the AP. We decided to do a selected angiography, in which a big diverticulum near the right tricuspid annulus was shown to be present. Ablation in this region successfully repressed the AP without any recurrences within a follow-up period of 12 months. The ventricular diverticulum-mediated AP is a novel variant of pre-excitation. It can serve as an anatomical substrate of supraventricular tachycardia, and can be ablated endocardially using an irrigation tip catheter within the diverticulum.
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
1302-1304Informations de copyright
© 2023 Wiley Periodicals LLC.
Références
Calkins H. The 2019 ESC guidelines for the management of patients with supraventricular tachycardia. Eur Heart J. 2019;40:3812-3813.
Long DY, Dong JZ, Liu XP, et al. Ablation of right-sided accessory pathways with atrial insertion far from the tricuspid annulus using an electroanatomical mapping system. J Cardiovasc Electrophysiol. 2011;22:499-505.
Minois D, Sellal JM, Magnin I, et al. Left ventricular diverticulum associated with two concealed atrioventricular accessory pathways. Eur Heart J. 2021;42:1714.
Li MM, Li JY, Sang CH, et al. Right free-wall accessory pathway with branched atrial insertions: clinical, electrocardiographic, and electrophysiological characteristics. Heart Rhythm. 2020;17:243-249.
Sun Y, Arruda M, Otomo K, et al. Coronary sinus-ventricular accessory connections producing posteroseptal and left posterior accessory pathways: incidence and electrophysiological identification. Circulation. 2002;106:1362-1367.
Chen M, Yang B, Ju W, et al. Right-sided free wall accessory pathway refractory to conventional catheter ablation: lessons from 3-dimensional electroanatomic mapping. J Cardiovasc Electrophysiol. 2010;21:1317-1324.
Guo XG, Sun Q, Ma J, et al. Electrophysiological characteristics and radiofrequency catheter ablation of accessory pathway connecting the right atrial appendage and the right ventricle. J Cardiovasc Electrophysiol. 2015;26:845-852.
Li MM, Sang CH, Jiang CX, Dong JZ, Long DY, Ma CS. Catheter ablation of a right epicardial accessory pathway via the small cardiac vein: two case reports. J Electrocardiol. 2019;52:106-108.
Yuan Y, Long D, Dong J, Tao L, Ma C. Successful ablation of a right atrium−axillary ventricular accessory pathway associated with Wolff-Parkinson-White syndrome. Pacing Clin Electrophysiol. 2017;40:1489-1491.