Key result
Radiofrequency catheter ablation from the left atrial septum by transseptal approach successfully modified slow-pathway conduction and prevented SVT induction in a patient with refractory AVNRT.
Case Report (n=1)
No
A transseptal approach for radiofrequency ablation guided by electro-anatomical mapping can be an effective alternative for AVNRT when the conventional venous approach fails.
Answers are grounded in this paper and cite their sources.
May offer bailout option in refractory AVNRT after failed conventional ablation; leaves open generalizability and safety in larger cohorts.
A 65 year-old female was admitted to our hospital because of syncope. She has been previously diagnosed with dilated cardiomyopathy. Twelve-lead electrocardiogram (ECG) presented narrow QRS tachycardia. Electrophysiological study and radiofrequency catheter ablation was performed. Under isoproterenol infusion, supraventricular tachycardia (SVT) was easily induced followed by critical AH interval. The mechanism of SVT was diagnosed with slow-fast atrioventricular nodal reentrant tachycardia (AVNRT). We tried slow-pathway ablation from venous approach targeted at the triangle of Koch using electrogram guide and anatomical approach. Slow-pathway conduction was not eliminated, however, and SVT still could be easily induced. Therefore we delivered radiofrequency (RF) from the left atrial (LA) septum by transseptal approach using an electro-anatomical mapping (EAM) system. After RF application at mid-septum from the LA, the slow-pathway conduction was modified and SVT could not be induced.
No takes yet. Share an insight, caveat, or question.
Higuchi et al. (2010) conducted a case report in Atrioventricular nodal reentrant tachycardia (AVNRT) (n=1). Radiofrequency catheter ablation from the left atrial septum by transseptal approach was evaluated on Elimination of slow-pathway conduction and non-inducibility of SVT. Radiofrequency catheter ablation from the left atrial septum by transseptal approach successfully modified slow-pathway conduction and prevented SVT induction in a patient with refractory AVNRT.
Synapse has enriched 10 related papers. Consider them for comparative context: