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Ablating the anteroseptal accessory pathway-ablation via the right internal jugular vein may improve safety and efficacy.
MedLine Citation:
PMID:  22869385     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Ablation of anteroseptal accessory pathways have historically been associated with lower success rates and a higher risk of AV nodal injury due to close proximity to the compact AV node. We describe the technique of ablation of anteroseptal APs via the right internal jugular vein (RIJV). METHODS: A retrospective analysis of all patients undergoing EP study and ablation at the Children's Hospital at Montefiore from 2008 to 2011 for SVT and/or WPW was performed. All patients less than 21 years of age who underwent ablation from the RIJV for either WPW or a concealed accessory pathway located in the anteroseptal region were included. RESULTS: A total of 16 patients met inclusion criteria and were the subject of this analysis. Twelve patients had WPW (75%) and four had a concealed AP (25%). Ablation was acutely successful in 94% of patients (15/16). In one patient, ablation was deferred due to close proximity to the compact AV node and risk of AV nodal injury. Radiofrequency (RF) was used in 14 patients and cryoenergy in two patients. There was no difference in WB CL pre- and post-ablation (p = 0.19). There were no complications encountered. At a mean follow-up of 15 ± 12 months, there were no recurrences. CONCLUSION: Ablation of APs in the right anteroseptal region can safely and effectively be performed via the RIJV with a success rate of 94%. This technique should be considered for ablation of APs located in the anterior septum.
Authors:
Michael P Dilorenzo; Robert H Pass; Lynn Nappo; Scott R Ceresnak
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-7
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  -     ISSN:  1572-8595     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatrics, The Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Rosenthal 4, Bronx, NY, 10467-2490, USA.
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