Volume 2 - Issue 7

WPW pathway ablated from uncommon location

Dr. T. Joseph*

Consultant Interventional Cardiologist & Electrophysiologist, Kauvery Hospital, Trichy รขโ‚ฌโ€œ 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

Dr. T. Joseph
Consultant Interventional Cardiologist & Electrophysiologist


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