Radiofrequency Catheter Ablation of an Incessant Supraventricular Tachycardia Initiated by a Hisian Parasystole |
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Authors: | FERNANDO E.S. CRUZ MARCIO FAGUNDES SILVIA BOGHOSSIAN JOSE CARLOS RIBEIRO LUTGARDE VANHEUSDEN IVAN G. MAIA |
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Affiliation: | Department of Arrhythmia and Elentrophysiology, Hospital do Cardiologia de Laranjeiras, Rio de Janeiro, Brazil |
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Abstract: | The coexistence of a pamsystolic focus, tachycardia dependent right bundle branch aberrancy, and an AV accessory pathway is reported here. This condition was present in a 40-year-old man, which led to an incessant AV reciprocating tachycardia. Further electrophysiological study revealed that the parasystolic focus was located somewhere in the His bundle; endocardial mapping disclosed a right posterior accessory pathway. Radiofrequency current was delivered at the atrial level of the right posterolateral AV groove and successfully ablated the accessory pathway, leading to a dramatic improvement in cardiac function. In conclusion, the recognition of the electrophysiological mechanism of incessant Supraventricular tachycardia was of crucial importance for the therapy decision. A definitive intervention using radiofrequency catheter ablation should be considered early and not postponed in patients with tachycardia-induced cardiomyopathy. |
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Keywords: | parasystole bundle branch block accessory pathway Wolff-Parkinson-White syndrome |
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