Key result
Radiofrequency ablation eliminates incessant AVRT from a slow-conducting accessory pathway at a prior incomplete ablation site.
Case Report (n=1)
Incomplete accessory pathway ablation can result in iatrogenic slowing of pathway conduction, creating a substrate for incessant orthodromic AVRT that requires repeat ablation.
Incomplete prior ablation may enable incessant AVRT amenable to repeat ablation; this case leaves open whether systematic re-mapping prevents such recurrences.
Introduction A 30‐year‐old woman with a history of prior ablation for a concealed left posteroseptal accessory pathway (AP) presented with incessant narrow QRS tachycardia, highlighting a rare complication of incomplete AP ablation. Methods and Results Adenosine transiently terminated the tachycardia, which recurred immediately. Electrophysiology study confirmed orthodromic atrioventricular reentry tachycardia (AVRT) due to a slow‐conducting AP at the previously ablated site. Three‐dimensional mapping localized the AP to the left posteroseptal region, and radiofrequency ablation at the shortest VA interval successfully eliminated the arrhythmia. Conclusion This case illustrates incessant AVRT caused by an iatrogenic slow‐conducting posteroseptal accessory pathway following incomplete ablation. Recognition of this mechanism is important to guide appropriate repeat ablation and prevent tachycardia‐induced cardiomyopathy.
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Liu et al. (2026) conducted a case report in Incessant narrow QRS tachycardia / Orthodromic atrioventricular reentry tachycardia (AVRT) (n=1). Radiofrequency ablation was evaluated on Elimination of the arrhythmia. Radiofrequency ablation successfully eliminated incessant AVRT caused by an iatrogenic slow-conducting accessory pathway from a prior incomplete ablation.
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