catheter ablation is an accepted, highly effective modality of treatment for cardiac arrhythmias in children. the success rate depends on the operator’s experience, especially in cases involving complex anatomies. we hereby report our recent experience of successful ablation of accessory pathways in three children with complex congenital heart diseases. the first case was a 7-year-old girl with...

background: noninvasive techniques for the localization of the accessory pathways (aps) might help guide mapping procedures and ablation techniques. we sought to examine the diagnostic accuracy of strain imaging for the localization of the aps in wolff-parkinson-white syndrome. methods: w e prospectively studied 25 patients (mean age = 32 ± 17 years, 58.3% men) with evidence of pre-excitation o...

this study was conducted on the atrioventricular node (avn) and atrioventricular bundle (avb) of fivefour-month-old ovine fetuses. the histological structure of these components was studied by routinehistological techniques and use of specific staining methods. the avn was caudally located adjacent to theroot of the aorta. it was almost spherical in shape and consisted of twisty cells. the node...

A cryosurgical instrument was used to ablate atrioventricular conduction. The procedure was carried out in 20 dogs and subsequently in three patients with drug resistant, life-threatening supraventricular tachycardias. In patients, the cryosurgical unit lowered the temperature of the His bundle area to 0 degrees C, effecting complete but reversible heart block. Rewarming resulted in resumption ...

Between March 1955 and March 1981, 52 adult patients (age 20 years or older) with partial atrioventricular canal (PAVC) were examined at the Mayo Clinic. Forty patients were in New York Heart Association (NYHA) functional class I or II. The ECG showed right bundle branch block with left-axis deviation in 48, first-degree atrioventricular block in 33 and atrial fibrillation in nine. Preoperative...

transcatheteraortic valve implantation, first introduced in 2002, has been established as an alternative modality for patients deemed not suitable for open-heart surgery. the anatomical vicinity of the atrioventricular node and the his bundle to the non-coronary and rightcoronary aortic cusps predisposes patients to conduction abnormalities in case of severe calcification or mechanical trauma d...

A case of isolated atrioventricular discordance in situs solitus is described. The importance of a well defined situs and of the presence of both ventricles in making this diagnosis is underlined and previous published reports reviewed. It is suggested that the haemodynamic concept of isolated atrioventricular discordance cannot be described only by the spatial relation between the ventricles (...

An unusual patient is described in whom electrophysiological studies strongly suggest the occurrence of Mahaim conduction. The patient whose electrocardiogram previously showed a left anterior hemiblock pattern then developed advanced atrioventricular (AV) block (AH block). Beats conducted through the atrioventricular node always had a short HV interval (20 ms) and QRS complexes of left anterio...

BACKGROUND Manifest nodofascicular/ventricular (NFV) pathways are rare. METHODS AND RESULTS From 2008 to 2013, 4 cases were identified with manifest NFV pathways from 3 centers. The clinical findings and ablation sites are reported. All 4 cases presented with a wide complex tachycardia but with different QRS morphologies. Case 1 showed a left bundle branch block/superior axis, case 2 showed a...

His bundle ablation was performed in a 48 year old man with drug refractory orthodromic atrioventricular reentrant tachycardia and paroxysmal atrial fibrillation. Reentry was caused by a left free wall concealed accessory pathway. Interruption of the His bundle by low energy direct current shock (25 J) was quickly followed by anterograde conduction via the accessory pathway, with various forms ...