Key result
Post-ablation isoproterenol triggers transient accelerated wide-complex rhythm matching prior preexcitation in para-Hisian pathway.
Why the study?
Automaticity from extra nodal accessory pathways is rare and not well characterized in WPW syndrome patients undergoing ablation.
Case Report (n=1)
This case report highlights a rare instance of catecholamine-dependent automaticity from an extra nodal accessory pathway following ablation.
Automaticity from extra nodal accessory pathways appears to be rare. We report the case of a man with the WPW syndrome who presented for repeat electrophysiological study and catheter ablation. After successful ablation of a para-Hisian accessory pathway, an isoproterenol challenge produced an accelerated wide complex rhythm that was dissociated from sinus rhythm and matched the previous pattern of maximal preexcitation. This automatic rhythm was transient and dependent on catecholamine administration. One month after successful ablation, an exercise treadmill test (ETT) did not demonstrate any pre-excitation or ectopy.
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Tseng et al. (2004) conducted a case report in WPW syndrome (n=1). Catheter ablation and isoproterenol challenge was evaluated on Rhythm response to isoproterenol challenge post-ablation. Isoproterenol challenge after successful ablation of a para-Hisian accessory pathway produced a transient, catecholamine-dependent accelerated wide complex rhythm matching previous preexcitation.
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