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Europace 2001 3(2):164-167; doi:10.1053/eupc.2001.0161
© 2001 by European Society of Cardiology
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CASE REPORT

Catheter ablation of an epicardial accessory pathway via the middle cardiac vein guided by monophasic action potential recordings

K. F. Kusano, H. Morita, Y. Fujimoto, E. Hirose and T. Ohe

Department of Cardiovascular Medicine, Okayama University Medical School Okayama, Japan

This report describes a case of permanent junctional reciprocating tachycardia (PJRT) that was ablated via the middle cardiac vein, guided by monophasic action potential recording. The patient was a 63-year-old woman who had been suffering from palpitation for 10 years. ECG during palpitation showed a narrow QRS tachycardia with a long RP interval. Electrophysiological study revealed that this tachycardia was an orthodromic reciprocating tachycardia, via an accessory pathway with a decremental property and a long ventriculoatrial interval (130 ms): PJRT. The earliest atrial activation during tachycardia was detected at the junction of the middle cardiac vein with the coronary sinus. Monophasic action potentials were recorded to confirm that the ablation catheter was in contact with the epicardium.

Key Words: Middle cardiac vein, catheter ablation, permanent form of junctional reciprocating tachycardia, epicardial accessory pathway

Correspondence: K. F. Kusano, MD, Department of Cardiovascular Medicine, Okayama University Medical School, shikata-cho 2-5-1, Okayama 700-8558, Japan.


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