WPW pathway ablated from uncommon location

Volume 2 - Issue 7

WPW pathway ablated from uncommon location

Dr. T. Joseph^*

Consultant Interventional Cardiologist & Electrophysiologist, Kauvery Hospital, Trichy – Heartcity, India

^*Correspondence: josephtheodore84@gmail.com

Patient

Drug resistant SVT due to WPW syndrome in a 17-year-old with history of failed ablation because of high risk location of the accessory pathway.

Figures 1-5 illustrate the successful performance of a high-risk procedure from an unusual location.

Fig. 1. Anteroseptal pathway - pre-ablation ECG.

Fig. 2. Localisation of pathways.

Fig. 3. Post ablation (DELTA lost).

Fig. 4. Ablation spot in aortic CUSP (near right coronary artery - RCC).

Fig. 5. Fused electrical signals at NCC - RCC site.

Parahisian pathways

• Anteroseptal and midseptal pathway are close to AV node and Bundle of HIS
• Ablating them directly can result in AV BLOCK.
• Aortic cusp gives a vantage point to access these accessory pathways.
• Our case is one example where we were very close to Right coronary but lucky to get rid of the pathway.

Dr. T. Joseph
Consultant Interventional Cardiologist & Electrophysiologist