81 PITFALLS IN LATERAL ACCESSORY PATHWAY ABLATION: THE IMPORTANCE TO RECOGNIZE MITRAL ISTHMUS CONDUCTION BLOCK DURING REDO PROCEDURES

Adenosine can improve the intra-atrial conduction block along the mitral annulus during accessory pathway ablation.

A 10-year-old boy with a supraventricular tachycardia was referred for catheter ablation. An electrophysiologic study revealed a left lateral concealed accessory pathway (AP). A few radiofrequency (RF) applications targeting the AP resulted in an inadvertent intra-atrial conduction block at the mitral isthmus without any damage to the AP. Adenosine was then administered during left ventricular ...

Mitral Isthmus Ablation: Is the Conduction Block Completed? The Importance of the Marshall Bundle Epicardial Connections.

A 66-year-old man underwent electrophysiological study and catheter ablation for persistent atrial fibrillation. At the beginning of the procedure, sinus rhythm was restored by internal cardioversion. Circumferential pulmonary vein isolation was performed, and the electric isolation of all 4 pulmonary veins was confirmed. Subsequently, linear ablation of a left atrial roof and the mitral isthmu...

Sequential Anterograde and Retrograde Conduction Block during Radiofrequency Ablation of an Accessory Pathway

We present an interesting image showing sequential loss of anterograde, and subsequently, retrograde conduction during radiofrequency ablation of an accessory pathway. We discuss the possible mechanisms and prior literature concerning this interesting finding.

Pre-procedural Clinical Parameters Determining Peri-Mitral Conduction Time during Mitral Isthmus Line Ablation Running title: Miyazaki et al.; Peri-Mitral Conduction Time during Linear Ablation

Transmural Ablation From the Mitral Annulus to the Left Lower Pulmonary Vein≠Mitral Isthmus Block

Great teaching value can come from showcasing an unusual phenomenon that serves as an aid to explain how best to approach mundane, common problems. In this installment of teaching rounds, Wakabayashi et al use an unusual activation sequence observed along the mitral annular atrial myocardium that was observed after ablation of the mitral isthmus to teach us about the pitfalls created by the com...