Mapping the left side of the anterior septum may be worthwhile if an accessory pathway potential is not appreciable along the tricuspid annulus to avoid AV block in patients with a typical anteroseptal accessory pathway ECG pattern.
Left septal mapping may be considered for typical anteroseptal pathways lacking right-sided potentials to avoid AV block; this case leaves open broader validation.
This case report describes a patient with Wolff-Parkinson-White syndrome in whom the ECG exhibited a typical pattern of an anteroseptal (superoparaseptal) accessory pathway. Successful radiofrequency catheter ablation was achieved from the septal side of the left ventricular outflow tract. It might be worthwhile to map the left side of the anterior septum if an accessory pathway potential is not appreciable along the tricuspid annulus to avoid the potential complication of AV block in patients with a typical anteroseptal accessory pathway ECG pattern.
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Miyauchi et al. (2004) studied this question.
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