Key result
Surgical resection resolves refractory posteroseptal accessory pathway formed by specialized conduction tissue.
Why the study?
Epicardial catheter mapping and ablation of a rapidly conducting posteroseptal accessory pathway had failed repeated ablation attempts and drug therapy, necessitating further characterization.
Case Report
Epicardial mapping and surgical resection of a refractory posteroseptal accessory pathway revealed specialized cardiac conduction tissue, explaining its resistance to catheter ablation and drug therapy.
Epicardial mapping may succeed for refractory posteroseptal APs; leaves open whether specialized conduction tissue predicts ablation failure.
Pericardial access permitted epicardial catheter mapping and ablation of a rapidly conducting posteroseptal accessory pathway (AP) that had failed repeated ablation attempts. Transient block was achieved at the site of an AP potential. The AP was visible at surgery and resected. Histologic examination revealed cells typical of specialized cardiac conduction tissue. The location, size, and presence of conduction tissue likely account for failure of catheter ablation and resistance to drug therapy.
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Sapp et al. (2001) conducted a case report in Refractory rapidly conducting posteroseptal accessory pathway. Epicardial catheter mapping, ablation, and surgical resection was evaluated on Electrophysiologic and histologic characterization. Epicardial mapping and surgical resection of a refractory posteroseptal accessory pathway revealed specialized conduction tissue, explaining its resistance to catheter ablation and drug therapy.
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