Typical Atrioventricular Bypass Tracts

Issa, Ziad F.; Miller, John M.; Zipes, Douglas P.

doi:10.1016/b978-0-323-52356-1.00018-9

Cited by 2 publications

(3 citation statements)

References 79 publications

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“…In our horse, the slightly larger ventricular compared to atrial signal suggested good position on the AV annulus. Within 2 s of RF energy delivery, the pathway potential disappeared and ablation was continued for 29 s. This outcome is consistent with results in humans and dogs, where good catheter position should eliminate AP conduction within 1 to 6 s, after which RF delivery is continued for up to 60 s 4,30,33,42 . The occasional AP conduction in the first hours after ablation, followed by complete conduction block also has been described in humans.…”

Section: Discussionsupporting

confidence: 87%

“…Right atrial pacing was performed to exactly localize the AP, because atrial pacing near the AP should result in maximal pre‐excitation. 4 In this patient, it was difficult to reach the right atrial free wall with the pacing catheter, and therefore it was not possible to localize the AP by means of atrial pacing. Pacing in the right ventricular apex did not result in retrograde conduction over the AP.…”

Section: Case Descriptionmentioning

confidence: 92%

“…The VCG identified a left, caudoventral direction of the ventricular wavefront, suggesting an AP localized at the craniodorsal region of the right ventricular free wall. Right atrial pacing was performed to exactly localize the AP, because atrial pacing near the AP should result in maximal pre‐excitation 4 . In this patient, it was difficult to reach the right atrial free wall with the pacing catheter, and therefore it was not possible to localize the AP by means of atrial pacing.…”

Section: Case Descriptionmentioning

confidence: 99%

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Three‐dimensional electro‐anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report

Buschmann

Steenkiste

Boussy

et al. 2023

Veterinary Internal Medicne

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We describe the diagnosis and treatment of an atrioventricular accessory pathway (AP) in a horse using 3‐dimensional electro‐anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA). During routine evaluation of the horse, intermittent ventricular pre‐excitation was identified on the ECG, characterized by a short PQ interval and abnormal QRS morphology. A right cranial location of the AP was suspected from the 12‐lead ECG and vectorcardiography. After precise localization of the AP using 3D EAM, ablation was performed and AP conduction was eliminated. Immediately after recovery from anesthesia an occasional pre‐excited complex still was observed, but a 24‐hour ECG and an ECG during exercise 1 and 6 weeks after the procedure showed complete disappearance of pre‐excitation. This case shows the feasibility of 3D EAM and RFCA to identify and treat an AP in horses.

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Section: Discussionsupporting

confidence: 87%

Section: Case Descriptionmentioning

confidence: 92%

Section: Case Descriptionmentioning

confidence: 99%

See 1 more Smart Citation

Three‐dimensional electro‐anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report

Buschmann

Steenkiste

Boussy

et al. 2023

Veterinary Internal Medicne

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Delta-wave automatic mapping of the manifest accessory pathway

Iacopino,

Fabiano,

Sorrenti

et al. 2024

Front. Cardiovasc. Med.

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BackgroundDespite the high success rate of radiofrequency catheter ablation (RFCA) in Wolff-Parkinson-White Syndrome (WPW), localizing the successful ablation site can be challenging and may require multiple radiofrequency (RF) applications.ObjectiveThis study aims to evaluate the efficacy of a novel workflow for the automatic and precise identification of accessory pathway ablation site, named Delta Wave Automatic Mapping.MethodsPatients undergoing a first procedure for RF ablation of a manifest accessory pathway were included. Electro-Anatomical Mapping (EAM) was performed with the CARTO 3 system (Biosense Webster, Johnson & Johnson Medical S.p.a., Irvine, CA) leveraging auto-acquisition algorithms already present in the CARTO 3 software. Mapping and ablation were performed with an irrigated tip catheter with contact force sensor. Procedure success was defined as loss of pathway function after ablation. The number of RF applications required and time to effect were measured for each patient. Recurrences were evaluated during follow-up visits. Additionally, at the end of each procedure, historical predictors of ablation success were measured offline to evaluate their relationship with the successful ablation site found with the novel workflow.ResultsA total of 50 patients were analysed (62% APs right and 38% APs left). All 50 APs were successfully eliminated in each procedure with a median Time-to-effect (TTE) of 2.0 (IQR 1.2–3.5) seconds. No AP recurrences during a median follow-up of 10 (IQR 6–13) months were recorded. Offline analysis of successful ablation site revealed a pre-ablation delta/ventricular interval of ≤−10 msec in 52% of the patients and in 100% of the patients the signal related to the Kent bundle was identified.ConclusionsThe novel workflow efficiently localizes APs without requiring manual annotations. Historical endocardial parameters predicting success were measured offline for each case and they corresponded to the ablation target automatically annotated by the proposed workflow. This novel mapping workflow holds promise in enhancing the efficacy of RFCA in the presence of manifest APs.

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Typical Atrioventricular Bypass Tracts

Cited by 2 publications

References 79 publications

Three‐dimensional electro‐anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report

Three‐dimensional electro‐anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report

Delta-wave automatic mapping of the manifest accessory pathway

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