Intra-atrial Conduction Block During Radiofrequency Ablation of Left-sided Accessory Pathways
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Key result
Left-sided accessory pathway ablation can induce mitral isthmus block and shift CS activation to concentric.
- n=2
Why the study?
Intra-atrial conduction block at the mitral isthmus during radiofrequency ablation of left lateral accessory pathways is an uncommon manifestation that requires better understanding.
Population
2 patients with orthodromic atrioventricular reentrant tachycardia using a concealed left-sided accessory pathway
Comparison
Radiofrequency ablation with observation of intra-atrial conduction block
Design
Case report
Authors
Discussion
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Implication
May manifest as altered CS activation post-ablation; leaves open prevalence and clinical sequelae in larger series.
Study Design
Type
Case Report (n=2)
Multicenter
No
Structured PICO
P
Population
Two patients (aged 38 and 52, 1 female) with orthodromic atrioventricular reentrant tachycardia due to a concealed left lateral accessory pathway who developed intra-atrial conduction block during radiofrequency catheter ablation.
I
Intervention
Radiofrequency ablation
O
Outcome
Intra-atrial conduction block at the level of the mitral isthmus
Awareness of intra-atrial conduction block during left lateral accessory pathway ablation is crucial to avoid erroneously diagnosing a second accessory pathway.
Limitations
- Small sample size inherent to a case report design
Cite This Study
Asvestas et al. (2022) conducted a case report in Orthodromic atrioventricular reentrant tachycardia with left-sided accessory pathway (n=2). Radiofrequency catheter ablation was evaluated on Observation of intra-atrial conduction block and successful elimination of the accessory pathway. Radiofrequency ablation of left-sided accessory pathways can induce intra-atrial conduction block at the mitral isthmus, abruptly changing coronary sinus activation from an eccentric to concentric sequence.
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