Why the study?
Does ablation at different insertion sites affect retrograde and anterograde conduction in a posteroseptal accessory connection?
Does ablation at different insertion sites affect retrograde and anterograde conduction in a posteroseptal accessory connection?
This case supports the impedance mismatch concept as the cause of unidirectional conduction block and demonstrates that the distal junction between the accessory connection and the myocardium is more vulnerable to ablation.
May guide site selection in unidirectional accessory pathway ablation; hypothesis-generating for impedance mismatch and should not change practice.
INTRODUCTION: The impedance mismatch hypothesis has been proposed as one of the mechanisms responsible for accessory connection conduction block. METHODS AND RESULTS: We describe a case in which retrograde conduction across a posteroseptal accessory connection was ablated at the atrial insertion site in the coronary sinus os, whereas anterograde conduction was ablated at the ventricular insertion site in the left ventricle. CONCLUSION: The evidence supports the impedance mismatch concept as the cause of unidirectional conduction block and shows that the distal junction between the accessory connection and the myocardium is more vulnerable to ablation.
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Vijgen et al. (1994) studied this question.
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