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European Heart Journal 1991 12(9):1321-1325;
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Successful catheter ablation by radiofrequency energy of posteroseptal accessory pathway in a patient with drug refractory Wolff—Parkinson—White syndrome

P. DELISE, A. BONSO, A. RAVIELE, R. CAZZIN, F. DI PEDE and E. PICCOLO

Division of Cardiology Hospital Umberto I, Mestre (Venice), Italy

Received 21 May 1990; revised 6 November 1990; .

Address for Correspondence: Dott. Pietro Delise, Via Felisati 66, 30171 Mestre (Venezia), Italia

Abstract

A 45-year-old patient with the Wolff-Parkinson-White syndrome suffering from recurrent intractable reciprocating atrioventricular tachycardia (RAVT) is reported. He used amiodarone, sotalol, quinidine, propafenone and flecainide unsuccessfully.

An electrophysiological study (EPS) performed with four catheters localized the site of the anomalous pathway in the ostium of the coronary sinus. In this region we could also record a Kent potential.

In the ostium of the coronary sinus, radiofrequencv energy was repeatedly applied until the conduction over the accessory pathway was abolished both in the anterograde and the retrograde direction. The Kent deflection detectable before ablation, could not be detected after it. During follow-up (1 month) the patient remained asymptomatic and the control EPS showed no evidence of pre-excitation, either anterogradely or retrogradely.

Key Words: Radiofrequency • Wolff-Parkinson-White • catheter ablation


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