Catheter Ablation of Accessory Pathways

Chugh, Aman; and, Frank Bogun; Morady, Fred

doi:10.1002/9780470696279.ch10

Cited by 3 publications

(8 citation statements)

References 61 publications

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“…This means that they do not exhibit the 'filtering' effect of the AV node in the event of atrial arrhythmias (Chugh et al, 2008). APs that are capable of rapid anterograde conduction can therefore conduct atrial fibrillation to the ventricles at much faster rates than the AV node will support (Mark et al, 2009).…”

Section: Accessory Pathwaysmentioning

confidence: 99%

“…These include Ebstein's anomaly, transposition of the great arteries, and hypertrophic cardiomyopathy (Triedman, 2009). Multiple pathways are possible, and are particularly common in Ebstein's anomaly (Chugh et al, 2008).…”

Section: Accessory Pathwaysmentioning

confidence: 99%

“…This is basically an electrical test of the heart. The conduction properties of the normal conduction system and AP are measured, and then rapid pacing is used to try to induce the clinical arrhythmia (Chugh et al, 2008). This process provides information about the location of the AP, its role in the clinical arrhythmia, and its ability to support rapid conduction.…”

Section: Treatment Of Wpwmentioning

confidence: 99%

“…On the surface ECG, pre-excitation should disappear. It may take multiple attempts to accurately locate the pathway, and therefore a number of 'burns' may be delivered before the AP is successfully ablated (Chugh et al, 2008). Each burn lasts up to 60 seconds, and patients may experience sharp chest pain during energy delivery, despite the use of opiates and benzodiazepines (Joseph and Rajappan, 2011;Lee and Linker, 2014).…”

Section: Treatment Of Wpwmentioning

confidence: 99%

“…Rarely, AP are found that connect to parts of the specialised conduction system. These may be atriofascicular (atria to right bundle branch), nodofascicular (AV node to right bundle branch), or nodoventricular (AV node to ventricle) (Chugh et al, 2008).…”

Section: Accessory Pathwaysmentioning

confidence: 99%

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Understanding the ECG. Part 5: Pre-excitation

Sampson

2016

British Journal of Cardiac Nursing

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Section: Accessory Pathwaysmentioning

confidence: 99%

Section: Accessory Pathwaysmentioning

confidence: 99%

Section: Treatment Of Wpwmentioning

confidence: 99%

Section: Treatment Of Wpwmentioning

confidence: 99%

Section: Accessory Pathwaysmentioning

confidence: 99%

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Understanding the ECG. Part 5: Pre-excitation

Sampson

2016

British Journal of Cardiac Nursing

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Cryoablation of Anteroseptal Accessory Pathways with a His Bundle Electrogram on the Ablation Catheter

Liberman

Spar

Nash

et al. 2014

Indian Pacing and Electrophysiology Journal

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BackgroundRadiofrequency catheter ablations of anteroseptal (AS) accessory pathways (AP) in pediatric patients have higher incidence of atrioventricular (AV) block than other AP locations. We report our experience using cryoablation in pediatric patients where a His bundle electrogram was noted on the ablation catheter at the site of the successful ablation.Methods and ResultsWe retrospectively reviewed all patients ≤21 years that underwent cryoablation for an AS AP from 2005 to 2012 at our institution (n=70). Patients with a His bundle electrogram noted on the cryoablation catheter at the location of the successful lesion were identified (n=6, 8.5%). All six patients had ventricular preexcitation. Median age of 15.9 years (7.2 - 18.2). AV nodal function was monitored during the cryoablation with intermittent rapid atrial pacing conducted through the AV node (n=2), with atrial extra-stimulus testing (n=2), or during orthodromic reentrant tachycardia (n=2). Acute success occurred in all patients. Two patients had early recurrence of AP conduction. Both patients underwent a second successful cryoablation, again with a His bundle electrogram on the cryoablation catheter. At a median follow-up of 13 months (3 to 37 months) there was no recurrence of accessory pathway conduction and AVN function was normal.ConclusionIn a small number of pediatric patients with AS AP with a His bundle electrogram seen on the ablation catheter, the use of cryotherapy was safe and effective for elimination of AP conduction without impairment of AV nodal conduction.

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Current Algorithms for the Diagnosis of wide QRS Complex Tachycardias

Vereckei

2014

CCR

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The differential diagnosis of a regular, monomorphic wide QRS complex tachycardia (WCT) mechanism represents a great diagnostic dilemma commonly encountered by the practicing physician, which has important implications for acute arrhythmia management, further work-up, prognosis and chronic management as well. This comprehensive review discusses the causes and differential diagnosis of WCT, and since the ECG remains the cornerstone of WCT differential diagnosis, focuses on the application and diagnostic value of different ECG criteria and algorithms in this setting and also provides a practical clinical approach to patients with WCTs.

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Catheter Ablation of Accessory Pathways

Cited by 3 publications

References 61 publications

Understanding the ECG. Part 5: Pre-excitation

Understanding the ECG. Part 5: Pre-excitation

Cryoablation of Anteroseptal Accessory Pathways with a His Bundle Electrogram on the Ablation Catheter

Current Algorithms for the Diagnosis of wide QRS Complex Tachycardias

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