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Electrophysiology, Mapping, and Ablation of Atrioventricular Accessory Pathways

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Wolff-Parkinson-White and Other Preexcitation Syndromes

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Abstract

This chapter presents mapping of non-decremental atrioventricular accessory pathways with description of techniques along the atrioventricular annuli from the atrial and ventricular aspects and local electrogram characteristics including activation timing and conduction intervals identifying target sites for successful catheter ablation of anterograde and retrograde pathway conduction. With regard to recordable deflections thought to be possible accessory pathway potentials but particularly not verified with pacing manoeuvres, the limitations of their use for mapping is analysed. As part of immediate assessment of elimination of accessory pathway conduction, the usefulness of intravenous adenosine by demonstrating atrioventricular block is shown. Due to ablation-induced injury, accessory pathways may develop markedly slow decremental conduction that may be overlooked and mask incomplete ablation, pointing out careful testing including adenosine. Furthermore, a phenomenon of cardiac memory characterized by repolarization abnormalities mimicking ischemia and appearing immediately post-ablation is presented. Finally, the purpose of this chapter was to describe in detail electrophysiologic characteristics, endocardial mapping, and catheter ablation of left-sided, septal, and right-sided atrioventricular accessory pathways.

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  1. Interventional Electrophysiology, CINRE Hospital, Bratislava, Slovakia

    Ján Hluchý

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  1. Ján Hluchý
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Hluchý, J. (2022). Electrophysiology, Mapping, and Ablation of Atrioventricular Accessory Pathways. In: Wolff-Parkinson-White and Other Preexcitation Syndromes. Springer, Cham. https://doi.org/10.1007/978-3-030-98749-7_6

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  • DOI: https://doi.org/10.1007/978-3-030-98749-7_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-98748-0

  • Online ISBN: 978-3-030-98749-7

  • eBook Packages: MedicineMedicine (R0)

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