A new technique for definitive surgical treatment of the preexcitation syndrome without the use of extracorporeal circulation has been elaborated and clinically used in 25 patients with Wolff-Parkinson-White syndrome. Seventeen patients had right parietal accessory atrioventricular connections and eight had septal connections. In patients with right-sided connections the fat pad in the coronary sulcus was dissected with an ultrasonic scalpel. Ablation of accessory atrioventricular connections was obtained by applying local cryothermia. The evidence of preexcitation and arrhythmias disappeared in all patients. All patients recovered without surgical complications and there were no deaths. The described technique offers considerable advantages over previous surgical methods in selected patients with Wolff-Parkinson-White syndrome.
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J Interv Card Electrophysiol
January 2025
Department of Cardiovascular Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsugagun, Tochigi, 321-0293, Japan.
Background: The conventional mapping approach for the atrioventricular accessory pathway (AP) involves point-by-point mapping to identify the connection sites of the AP to the atria or ventricle and accurate interpretation of local electrograms. Omnipolar mapping technology (OMT) explains how vector and wave speed are produced by using both unipolar and bipolar signals to obtain omnipolar signals, directions, and conduction velocity. The aim of this study is to verify the effectiveness of OMT for catheter ablation of AP.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
January 2025
Division of Cardiology, Section of Cardiac Electrophysiology, University of California San Francisco, San Francisco, California, USA.
We encountered a single case in which a transition between orthodromic reciprocating tachycardia with a concealed nodoventricular pathway and atrioventricular nodal reentrant tachycardia with a bystander nodoventricular pathway was observed.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Arrhythmology, Pacing and Electrophysiology Unit, Cardiology Service, Santa Marta Hospital, Central Lisbon Hospital University Centre, R. de Santa Marta 50, Lisboa 1169-024, Portugal.
Background: Accessory pathways (AP) are associated with an increased risk of atrioventricular reentry tachycardia (AVRT), presenting as a wide QRS tachycardia if the mechanism is antidromic. Rarely, AVRT may not respond to adenosine, suggesting a duodromic mechanism if the patient has multiple APs. Herein, we present a case of a male patient with multiple APs, wide QRS complex tachycardia, and resistance to adenosine.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
January 2025
Douala Gyneco-obstetric and Pediatric Hospital/University of Douala, Douala, Cameroon.
J Cardiovasc Electrophysiol
December 2024
Department of Cardiovascular Medicine, University of Yamanashi, Chuo, Japan.
Introduction: Catheter ablation (CA) is the first-line treatment with a high success rate for patients with symptomatic Wolff-Parkinson-White syndrome, while three-dimensional (3D) mapping systems enable the identification of accessory pathways (APs). We aimed to develop a novel mapping method using wave-speed mapping (WSM) to determine AP locations and CA outcomes.
Methods And Results: This study included 19 patients diagnosed with atrioventricular (AV) reciprocating tachycardia.
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