Key result
Radiofrequency ablation successfully eliminates recurrent SVT by targeting a rare right atrial-to-left ventricular pathway.
Why the study?
Rare accessory pathways in congenital heart disease pose challenges due to difficult anatomy, requiring advanced mapping tools for detection and ablation.
Case Report (n=1)
No
This report demonstrates the first successful mapping and ablation of a rare accessory pathway connecting the right atrial appendage to the morphologic left ventricle in a patient with congenitally corrected transposition of the great arteries.
Answers are grounded in this paper and cite their sources.
Remote navigation enabled ablation of a rare RAA-LV pathway in ccTGA; single-case evidence leaves generalizability and durability open.
Key Teaching Points•The use of tools such as the remote navigation catheter should be encouraged, as they increase the likelihood of detecting elusive pathways, while allowing for safe mapping.•Understanding the embryology of an accessory pathway is important in comprehending its anatomy, which can assist with tracing the pathway and isolating it for ablation when usual approaches fail.•Rare accessory pathways are found in normal healthy hearts and congenital heart disease alike, but the latter situations pose challenges owing to difficult anatomy. •The use of tools such as the remote navigation catheter should be encouraged, as they increase the likelihood of detecting elusive pathways, while allowing for safe mapping.•Understanding the embryology of an accessory pathway is important in comprehending its anatomy, which can assist with tracing the pathway and isolating it for ablation when usual approaches fail.•Rare accessory pathways are found in normal healthy hearts and congenital heart disease alike, but the latter situations pose challenges owing to difficult anatomy.
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Radhakrishnan et al. (2023) conducted a case report in Congenitally corrected transposition of the great arteries (ccTGA) and Wolff-Parkinson-White (WPW) syndrome (n=1). Radiofrequency ablation was evaluated on Successful ablation of the accessory pathway and absence of arrhythmia recurrence. Radiofrequency ablation successfully treated recurrent supraventricular tachycardia by isolating a rare accessory pathway from the right atrial appendage to the anatomic left ventricle.
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