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Europace Advance Access published online on November 10, 2006
Europace, doi:10.1093/europace/eul122
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

CASE REPORT

Catheter ablation of anteroseptal accessory pathway in the non-coronary aortic sinus

He Huang, Xingxiang Wang, Feifan Ouyang* and Matthias Antz

II. Medizinische Abteilung, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099 Hamburg, Germany

We report a patient with atrioventricular reentrant tachycardia (AVRT) with bidirectional conduction over an anteroseptal accessory pathway (AP) who underwent successful ablation in the non-coronary aortic sinus (AS). In three previous attempts, the intracardiac recordings showed an anteroseptal AP with antegrade and retrograde conduction that failed to be ablated in spite of radiofrequency (RF) applications from the right and left anteroseptal regions. During the study, the earliest atrial activation during tachycardia was recorded in the non-coronary AS preceding the atrial activation at the His bundle (HB) region by 24 ms, and the anteroseptal AP was successfully blocked by one single ablation in the non-coronary AS. These data strongly suggest that careful mapping of an anteroseptal AP in the non-coronary AS may provide an alternative ablation approach in patients with previously failed ablation.

Key Words: Atrioventricular reentrant tachycardia, Accessory pathway, Catheter ablation, Aorta, Sinus of Valsalva

* ouyangfeifan{at}aol.com


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