A 24-year-old-female with Ebstein anomaly, pre-excitation (ECG#1), and history of syncope was referred for catheter ablation. The procedure was guided by fluoroscopy, electro-anatomical mapping system (CARTO 3TM, Biosense-Webster), and intracardiac echocardiography (ICE) (Acunav, Siemens). At first, ICE (upper Panel) was used to define the true location of tricuspid annulus (TA) by course of th...

While Drs. Wolff, Parkinson, and White fully described the syndrome that bears their names in 1930, prior case reports had already described the essentials. Over the ensuing century this syndrome has captivated the interest of anatomists, clinical cardiologists, and cardiac surgeons. Stanley Kent described lateral muscular connections over the atrioventricular (AV) groove, which he felt were th...

OBJECTIVES This study was performed to evaluate the usefulness of temperature-guided radiofrequency catheter ablation for the elimination of accessory pathway conduction in patients with Wolff-Parkinson-White syndrome. METHODS Temperature-guided radiofrequency catheter ablation was attempted in 138 patients with 144 accessory pathways (88 pathways along the left free wall, 5 in the anterosept...

A 30year old patient presented to us with recurrent episodes of palpitation and documented tachycardia. In all his presentations a wide QRS tachycardia was recorded. The baseline ECG showed pre excitation. The 12 lead ECG of the tachycardia and the baseline ECG is shown in Fig. 1A. During EP study the patient had baseline pre excitation and the HV interval was 16 ms. A duo-decapolar halo (HL) c...

BACKGROUND This study evaluates the role of RR interval distribution pattern as an outcome predictor of radiofrequency (RF) modification of atrioventricular (AV) node in chronic atrial fibrillation (AF) and attempts to elucidate the likely mechanism of rate control. METHODS AND RESULTS Sixty-five patients with chronic AF underwent AV node modification. The RR interval distribution pattern was...

BACKGROUND The purpose of this study was to evaluate electrode temperatures obtained using a radiofrequency ablation system that incorporates closed loop feedback control to achieve preset target electrode temperatures and to determine if closed loop temperature control results in a lower incidence of developing a coagulum. METHODS AND RESULTS Two hundred seventy patients underwent catheter a...

BACKGROUND Accessory pathway (AP) ablation is not always easy. Our purpose was to assess the age-related prevalence of AP location, electrophysiological and prognostic data according to this location. METHODS Electrophysiologic study (EPS) was performed in 994 patients for a pre-excitation syndrome. AP location was determined on a 12 lead ECG during atrial pacing at maximal preexcitation and ...

Accessory atrioventricular pathways (AP) and dual AV nodal physiology are common substrates for paroxysmal supraventricular tachycardias (SVT) in children and adolescents. Definitive treatment can be achieved by catheter ablation with either radiofrequency (RF) or cryoenergy. Aim of this study was to assess effectiveness and safety of RFand cryoenergy ablation in a paediatric population. During...

BACKGROUND Percutaneous ablation of accessory pathways with the use of a defibrillator can be accomplished with high-energy direct-current (DC) shocks of 150-400 J, but complications include cardiac tamponade and sudden cardiac death, mostly resulting from significant electrical arcing and barotrauma. A new low-energy DC power source with a brief time-constant capacitive discharge delivers shoc...

While Drs Wolff, Parkinson, and White fully described the syndrome in 1930, prior case reports had described the essentials. Over the ensuing century this syndrome has captivated the interest of anatomists, clinical cardiologists, and cardiac surgeons. Stanley Kent described lateral muscular connections over the atrioventricular (AV) groove which he felt were the normal AV connections. The norm...