Key result
Cryoablation of a concealed parahisian accessory pathway resulted in transient manifestation of a fully preexcited sinus rhythm of parahisian AP morphology in a 16-year-old male.
Case Report (n=1)
Cryoablation of a concealed parahisian accessory pathway can result in paradoxical preexcitation, potentially due to inadvertent AV nodal block, source-sink mismatch, or activation of a dormant anterograde pathway.
Alerts operators to possible transient preexcitation during parahisian cryoablation; hypothesis-generating for mechanisms including AV nodal block or dormant pathway activation.
A 16-year-old male presented with an orthodromic atrioventricular reentrant tachycardia over a concealed parahisian accessory pathway (AP). Cryoablation of the AP resulted in transient manifestation of a fully preexcited sinus rhythm of parahisian AP morphology. Potential causes for the paradoxical preexcitation include inadvertent atrioventricular nodal block, sourse-sink mismatch, as well as the activation of a dormant AP capable of anterograde conduction.
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Åkerström et al. (2018) conducted a case report in Orthodromic atrioventricular reentrant tachycardia over a concealed parahisian accessory pathway (n=1). Cryoablation was evaluated. Cryoablation of a concealed parahisian accessory pathway resulted in transient manifestation of a fully preexcited sinus rhythm of parahisian AP morphology in a 16-year-old male.
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