Catheter ablation of para-Hisian accessory pathways via a direct superior vena cava approach successfully eliminated the pathway in 93.3% of patients, with 96.7% long-term freedom from arrhythmia.
Observational (n=30)
Yes
Does radiofrequency catheter ablation via a direct superior vena cava approach safely and effectively eliminate para-Hisian accessory pathways in patients?
Catheter ablation of para-Hisian accessory pathways via a direct superior vena cava approach is highly effective and safe, offering a viable alternative for patients who failed conventional IVC approaches.
BACKGROUND: Radiofrequency (RF) catheter ablation of para-Hisian accessory pathways (APs) can be challenging due to proximity to the conduction system. METHODS: A total of 30 consecutive patients with para-Hisian AP were enrolled for ablation in three centers, 12 (40%) of whom had previously failed attempted ablation from the inferior vena cava (IVC) approach. Ablation was preferentially performed using a superior approach from the superior vena cava (SVC) in all patients. RESULTS: The para-Hisian AP was eliminated from the SVC approach in 28 of 30 (93.3%) patients. In the remaining two patients, additional ablation from IVC was required to successfully eliminate the AP. There were two patients experienced reversible complete atrial-ventricular block and PR prolongation during the first RF application. Long-term freedom from recurrent arrhythmia was achieved in 29 (96.7%) patients over a mean follow-up duration of 15.6 ± 4.6 months. CONCLUSION: Catheter ablation of para-Hisian AP from above using a direct SVC approach is both safe and effective, and should be considered especially in patients who have failed conventional ablation attempts from IVC approach.
Chai et al. (Fri,) conducted a observational in Para-Hisian accessory pathways (n=30). Catheter ablation via a direct superior vena cava (SVC) approach was evaluated on Elimination of the para-Hisian AP from the SVC approach. Catheter ablation of para-Hisian accessory pathways via a direct superior vena cava approach successfully eliminated the pathway in 93.3% of patients, with 96.7% long-term freedom from arrhythmia.