Radiofrequency ablation of idiopathic left anterior fascicular tachycardia.

Introduction: A 45-year-old man with idiopathic ventricular tachycardia (VT) having a right bundle branch block configuration with right-axis deviation underwent an electrophysiologic test.

Methods And Results: Mapping demonstrated a site on the anterobasal wall of the left ventricle where there was an excellent pace map and an endocardial activation time of -20 msec, but radiofrequency catheter ablation at this site was unsuccessful. At a nearby site, a presumed Purkinje potential preceded the by 30 msec during VT and sinus rhythm, and catheter ablation was effective despite a poor pace map and an endocardial ventricular activation time of zero.

The economic burden of unrecognized vasodepressor syncope.

Background: The objective of this study was to describe the cost of prior diagnostic evaluation in patients referred for evaluation of syncope whose history was typical of vasodepressor syncope.

Methods And Results: Thirty consecutive patients who were referred for evaluation of syncope of undetermined origin and whose history was highly suggestive of vasodepressor syncope participated in this study. These 30 patients represented 19% of 158 patients referred for evaluation of syncope during the period of enrollment.

Inducibility of atrial fibrillation before and after radiofrequency catheter ablation of accessory atrioventricular connections.

Introduction: The purpose of this study was to evaluate the inducibility of atrial fibrillation in patients with an accessory atrioventricular connection (AAVC) and to determine if the inducibility of atrial fibrillation is altered after successful radiofrequency catheter ablation of the AAVC.

Methods And Results: Thirty-seven patients with an AAVC and 36 control patients were prospectively evaluated using a standardized atrial pacing protocol. The high right atrium was paced using a 25-beat drive train, 1.

Association between atrioventricular node reentrant tachycardia and inducible atrial flutter.

Objectives: The purpose of this study was to evaluate the inducibility of atrial flutter in patients with atrioventricular (AV) node reentrant tachycardia and to determine the effect of radio-frequency ablation of the slow AV node pathway on the inducibility of atrial flutter.

Background: Studies have shown that both AV node reentrant tachycardia and atrial flutter are reentrant arrhythmias having an area of slow conduction that is located in the low posterior right atrium near the ostium of the coronary sinus.

Methods: Ninety-one patients were prospectively evaluated using a standardized atrial pacing protocol.

A randomized, prospective comparison of anterior and posterior approaches to radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia.

Background: Two different techniques have been developed for radiofrequency catheter ablation of typical atrioventricular nodal reentry (AVNRT). Lesions made anteriorly near the apex of the triangle of Koch usually eliminate fast pathway function, whereas lesions made posteriorly near the ostium of the coronary sinus selectively affect slow pathway function. The current study compares the safety, efficacy, and electrophysiological effects of these two techniques in a prospective, randomized fashion.