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November 21, 2024Journal of Cardiac ArrhythmiasOpen Access

Catheter ablation at the base of the right atrial appendage successfully eliminated pre-excitation and prevented AVRT recurrence in a patient with three prior unsuccessful ablations.

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Why the study?

Pseudo-refractory AVRT can be caused by rare right atrial appendage accessory pathways that are easily overlooked when standard ablation around the tricuspid valve annulus fails.

Design

Case report

Key result

Catheter ablation at the base of the right atrial appendage successfully eliminated pre-excitation and prevented AVRT recurrence in a patient with three prior unsuccessful ablations.

Authors

LOLucas Hollanda OliveiraCLChristian Moreno LuizeRCRicardo Sobral de Carvalho

Discussion

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Overview

May warrant appendage mapping in refractory AVRT; leaves open optimal strategies until larger series confirm prevalence.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P
Population
A 24-year-old male with recurrent atrioventricular reentrant tachycardia and three prior unsuccessful ablations, followed for nearly two years post-ablation.
I
Intervention
Catheter ablation at the base of the right atrial appendage (anatomical approach)
O
Outcome
Elimination of pre-excitation and non-inducibility of AVRT

An anatomical ablation approach targeting the base of the right atrial appendage can successfully treat pseudo-refractory AVRT caused by a right atrial appendage accessory pathway.

Limitations

  • Single case report
  • Anatomical risks of right atrial appendage ablation including perforation and coronary artery injury

Cite This Study

Oliveira et al. (2024) conducted a case report in Atrioventricular reentrant tachycardia (AVRT) (n=1). Catheter ablation at the base of the right atrial appendage was evaluated on Elimination of pre-excitation and AVRT recurrence. Catheter ablation at the base of the right atrial appendage successfully eliminated pre-excitation and prevented AVRT recurrence in a patient with three prior unsuccessful ablations.

synapsesocial.com/papers/6a932f8a6b34f0e4f05fa84ehttps://doi.org/10.24207/jca.v37i1.3567
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Catheter Ablation of Accessory Atrioventricular Connection between Right Atrial Appendage to Right Ventricle1998 · 31 citations
  2. 2Atrial appendage accessory pathway ablation: Tips for recognition and approach to ablation2023 · 1 citations
  3. 3Intraatrial conduction block in the right posteroseptal region after failed accessory pathway ablation—Importance of delineation of three-dimensional pathway geometry2021
  4. 4Left atrioventricular accessory pathway with Mahaim fiber characteristics: a rare case report2025
  5. 5Successful Elimination of Concealed Accessory Pathway‐Mediated Tachycardia by Ablation of AV Nodal Slow Pathway2006 · 8 citations