3D Electroanatomic Mapping of an Extreme Oblique Accessory Pathway in Wolff-Parkinson-White Syndrome

Figures

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  Figure 1. (A) Baseline and (B) post-ablation 12-lead electrocardiograms (ECGs). Baseline ECG demonstrates a delta wave suggestive of a left-sided posterolateral accessory pathway. Post-ablation ECG demonstrates absence of pre-excitation, indicating successful ablation of the accessory pathway.

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  Figure 2. 3D electroanatomic map of a posterolateral, extremely oblique AP. (A) The earliest AAS was identified within the CS at the 2 o’clock position of the MA during ventricular pacing. (B) The earliest VAS was identified at the 5 o’clock position of the MA during atrial pacing. Local activation times are colour coded, with white representing early activation times and blue representing late activation times. The site of successful ablation was located at the earliest ventricular insertion (VAS; B). AAS, atrial activation site; AP, accessory pathway; CS, coronary sinus; MA, mitral annulus; VAS, ventricular activation site.