Journal of Arrhythmia (Jan 2005)

Efficacy of Electroanatomical Mapping for Radiofrequency Ablation of Right-sided Accessory Pathways

  • Tiejun Li, MD,
  • Yasushi Miyauchi, MD,
  • Yoshinori Kobayashi, MD,
  • Yu-ki Iwasaki, MD,
  • Tsutomu Horie, MD,
  • Hiroshi Taniguchi, MD,
  • Yasuhiro Hirasawa, MD,
  • Mitsunori Maruyama, MD,
  • Akira Ueno, MD,
  • Junko Abe, MD,
  • Takao Katoh, MD,
  • Teruo Takano, MD

DOI
https://doi.org/10.1016/S1880-4276(05)80005-5
Journal volume & issue
Vol. 21, no. 4
pp. 459 – 464

Abstract

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Introduction: Due to the difficulty in performing detailed mapping around the tricuspid annulus and the high occurrence of mechanical trauma during the procedure, the outcome of right-sided accessory pathway (AP) ablation still has a relatively high primary failure and recurrence rate. Methods and Results: Six patients with right free-wall APs underwent electroanatomical mapping. The AP had retrograde unidirectional conduction in 3 patients, anterograde unidirectional conduction in 1 patient, and bidirectional conduction in 2 patients. The right atrial (RA) activation map was constructed during right ventricular (RV) pacing (n = 5), and the RV activation map was constructed during RA pacing (n = 3). During mapping, the AP conduction was interrupted by catheter mechanical trauma in 3 patients. The first RF application successfully eliminated the AP conduction within 2 seconds in 3 patients with concealed pathways. In the remaining 3 patients, rescue RF energy was delivered at the tagged bump site on the map. The mean procedure time was 214 ± 77 minutes, and mean fluoroscopy time 63 ± 23 minutes. No recurrence occurred during 12 ± 3.2 months of followup in any of the patients. Conclusions: With the guidance of an electroanatomical mapping system, right-sided accessory pathways can be satisfactorily eliminated without later recurrence.

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