Abstract
The impact of high-density atrioventricular dual-chamber mapping in a patient with a left epicardial accessory pathway
Highlights
Accessory pathways (APs) are one of the most common causes of supraventricular tachycardia, usually exist on the endocardium, and are located around the atrioventricular valves
The earliest atrial activation site (EAAS) during ventricular pacing recorded by an ultra-high-density mapping system (Rhythmia; Boston Scientific, Marlborough, MA) was 6 o’clock on the mitral annulus (Figure 1A–D), which did not exhibit any decremental properties, and the conduction was not interrupted by an adenosine triphosphate infusion
Several ablation attempts were tried from the left atrium (LA), and the retrograde conduction always terminated within a few seconds; it KEYWORDS Accessory pathway; Atrioventricular dual-chamber mapping; Catheter ablation; Epicardial connection; Ultra-high-density mapping (Heart Rhythm Case Reports 2020;6:888–890)
Summary
Accessory pathways (APs) are one of the most common causes of supraventricular tachycardia, usually exist on the endocardium, and are located around the atrioventricular valves. Connections between the coronary sinus (CS) and ventricle have been reported previously, ablation of which can be successful only within the CS.[1,2] to the best of our knowledge, the detailed conduction pattern of left epicardial APs using ultra-high-density mapping has never been reported
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