Reappraisal of radiofrequency ablation of multiple accessory pathways

Ablation of Atrioventricular Accessory Pathways: Current Technique‐State of the Art

“…The prevalence of multiple APS varies widely between 5% and 33% (in surgically treated and catheter ablation patients). [99][100][101][102][103][104][105][106][107][108] Patients with multiple APS exhibit a higher incidence (23% vs 10%) of right free-wall APS and a lower incidence (44% vs 56%) of left free-wall APS compared with patients with a single AP. Also, the overall prevalence of concealed APS in patients with multiple APS is 45%, which is nearly twice as high as that in patients with a single AP (24%).…”

Three-Catheter Technique for Ablation of Left-Sided Accessory Pathways in Wolff-Parkinson-White is Less Expensive and Equally Successful When Compared to a Five-Catheter Technique

“…After successful ablation of any AP, there is a possibility that additional tachycardia mechanisms may be identified. The incidence of multiple APs in patients with structurally normal hearts is estimated to be between 8% and 25% . In these cases, if the procedure was started with only three catheters, the introduction of further catheters may become necessary to localize and ablate additional foci of tachycardia and this may potentially introduce a possible disadvantage of venous puncture under full heparinization.…”

Retrograde Multiple and Multifiber Accessory Pathway Conduction in the Wolff‐Parkinson‐White Syndrome:

“…Based on the results of radiofrequency catheter ablation, the accessory pathways were classified into retrograde single, multiple, and multifiber pathways. Retrograde mtiltiple accessory pathways were defined following previously described criteria: (1) different atrial activation sequences during orthodromic AVRT or ventricular pacing; and (2) persistence of retrograde accessory pathway function > 2 to 3 cm apart from the site of sue-cessful ablation of the original accessory path-^y 14,15 Retrograde multifiber accessory pathways were defined as pathways with broad and multisegmental atrial insertions requiring multiple segmental ablations > I cm but < 2 cm apart along the AV ring with stepwise modifications in a preexcitation and/or retrograde activation pattern. "''Ŝ tatistical Analysis Data are expressed as mean ± SD.…”