Document Detail

Ablation of right-sided accessory pathways with atrial insertion far from the tricuspid annulus using an electroanatomical mapping system.
MedLine Citation:
PMID:  21087327     Owner:  NLM     Status:  In-Process    
BACKGROUND: It is difficult to ablate a right-sided accessory pathway (AP) with atrial insertion far from the tricuspid annulus (TA). We report our initial experience of ablating this rare AP by a 3-dimensional electroanatomical mapping system (CARTO).
METHODS: From January of 2006 to April of 2008, 18 patients with right-sided APs who failed previous outside ablations were enrolled in this study. Retrograde AP conduction was mapped during pacing at the right ventricular apex by activation-mapping the right atrium (RA) using a 3-dimensional electroanatomical mapping system. AP atrial insertion was defined as the earliest retrograde atrial activations and successful ablation of the APs at this site.
RESULTS: Among the 18 patients who had failed previous ablation, 10 patients (7 patients with right manifest APs and 3 patients with right conceal APs) had atrial insertions far from the TA. Of the 10 patients, the atrial insertions were found at the base of the RA appendage in 3 patients, at the high lateral RA in 5 patients, at the low lateral RA in other 2 patients. Ablation at the atrial insertions successfully abolished the AP conduction. The mean distance between the atrial insertion sites and the TA was 20.2 ± 2.7 mm. No patients reported recovered AP conduction or recurrent tachycardias after 6-month follow-up.
CONCLUSIONS: The right-sided APs may have atrial insertion far from the TA. These uncommon variation of APs can be reliably identified and ablated using CARTO system.
De-Yong Long; Jian-Zeng Dong; Xing-Peng Liu; Ri-Bo Tang; Man Ning; Ling-Yun Gao; Rong-Hui Yu; Dong-Ping Fang; Chen-Xi Jiang; Yi-Qiang Yuan; Cai-Hua Sang; Xian-Dong Yin; Gang Chen; Xin-Yong Zhang; Cui Liang; Chang-Sheng Ma
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Publication Detail:
Type:  Journal Article     Date:  2010-11-18
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  22     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  499-505     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Cardiology Department, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
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