This case report suggests the possibility of anatomic compartmentalization of antegrade and retrograde conduction along an accessory pathway in WPW syndrome.
May suggest compartmentalized accessory pathway conduction in WPW; leaves open whether site-specific ablation strategies warrant prospective evaluation.
Histopathologically, accessory atrioventricular (AV) pathways comprise tiny strands of working myocardium that traverse the AV groove and link between the atrial and ventricular myocardium. Antegrade and retrograde conduction in bidirectional accessory pathways have generally been considered to occur along the same fibers. This report details the successful catheter ablation of a left free wall accessory pathway with radiofrequency energy. Antegrade and retrograde conduction of the pathway were abolished sequentially by separate episodes of energy delivered at anatomically discrete though closely adjacent sites along the mitral annulus. This finding raises the interesting possibility of anatomic "compartmentalization" of antegrade and retrograde conduction along an accessory pathway.
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Tai et al. (1992) studied this question.
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