Abstract
Beginning in the mid-1970s, surgical ablation of accessory atrioventricular (AV) pathways (APs) was performed at a limited number of centers. The potential to target APs by catheter ablation became apparent in 1982, when Scheinman and coworkers introduced catheter ablation of the AV junction using high-energy direct current (DC) shocks from a defibrillator to produce AV block as palliative therapy for drug-resistant supraventricular tachyarrhythmias. Early attempts at DC shock ablation of APs were associated with some success,1 but the large area of barotrauma limited focused ablation and was associated with risk of cardiac perforation, AV block, and coronary artery injury.
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