Radiofrequency Catheter Ablation of Posteroseptal Atrioventricular Accessory PathWays Location-Specific Electrographic Characteristics of Successful Ablation Sites

Yohkoh Soejima; Yoshito Iesaka; Atsushi Takahashi; Masahiko Goya; Takeshi Tokunaga; Hiroshi Amemiya; Hideomi Fujiwara; Jun-ichi Nitta; Akihiko Nogami; Kazutaka Aonuma; Michiaki Hiroe; Fumiaki Marumo; Masayasu Hiraoka

doi:10.1253/jcj.61.46

Clinical Study

Radiofrequency Catheter Ablation of Posteroseptal Atrioventricular Accessory PathWays

Location-Specific Electrographic Characteristics of Successful Ablation Sites

Yohkoh Soejima, Yoshito Iesaka, Atsushi Takahashi, Masahiko Goya, Takeshi Tokunaga, Hiroshi Amemiya, Hideomi Fujiwara, Jun-ichi Nitta, Akihiko Nogami, Kazutaka Aonuma, Michiaki Hiroe, Fumiaki Marumo, Masayasu Hiraoka

Author information

Yohkoh Soejima
Cardiovascular Center, Tsuchiura Kyodo Hospital
Yoshito Iesaka
Cardiovascular Center, Tsuchiura Kyodo Hospital
Atsushi Takahashi
Cardiovascular Center, Tsuchiura Kyodo Hospital
Masahiko Goya
Cardiovascular Center, Tsuchiura Kyodo Hospital
Takeshi Tokunaga
Cardiovascular Center, Tsuchiura Kyodo Hospital
Hiroshi Amemiya
Cardiovascular Center, Tsuchiura Kyodo Hospital
Hideomi Fujiwara
Cardiovascular Center, Tsuchiura Kyodo Hospital
Jun-ichi Nitta
Second Department of Medicine
Akihiko Nogami
Second Department of Medicine
Kazutaka Aonuma
Second Department of Medicine
Michiaki Hiroe
Second Department of Medicine
Fumiaki Marumo
Second Department of Medicine
Masayasu Hiraoka
Department of Cardiovascular Disease of Medical Research Institute, Tokyo Medical and Dental University

Keywords: Radiofrequency catheter ablation, Posteroseptal atrioventricular accessory pathway, Wolff-Parkinson-White syndrome

JOURNAL FREE ACCESS

1997 Volume 61 Issue 1 Pages 46-54

DOI https://doi.org/10.1253/jcj.61.46

Details

Abstract

The electrographic features of successful sites of radiofrequency catheter ablation were analyzed in 33 cases of posteroseptal accessory pathways and compared with those from 155 cases of free wall accessory pathways. The atrioventricular intervals in the posteroseptal cases were significantly longer than in the free wall cases (posteroseptal vs left and right free wall; 38 vs 33 and 26 msec, respectively; p<0.05), and the incidences of continuous electrograms (42 vs 63 and 79%; p<0.01) and PQS-pattern unipolar electrograms (50 vs 76 and 78%; p<0.05) were significantly lower in the posteroseptal cases. The V-delta intervals in the posteroseptal cases were significantly longer than in the left free wall cases (17 vs 13 msec; p<0.05), but shorter than in the right free wall cases (17 vs 23 msec; p<0.05). No statistically significant difference in the incidence of Kent potentials among the 3 groups was observed. In radiofrequency ablation of posteroseptal pathways, the length of the atrioventricular interval and the incidences of continuous electrograms and PQS-pattern unipolar electrograms may be unsatisfactory even at the appropriate target site, but the V-delta interval and Kent potential are good indicators of suitable target sites. (Jpn Circ J 1997; 61: 46 - 54)

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