Ablación por radiofrecuencia de múltiples vías accesorias auriculoventriculares en un paciente con fibrilación auricular sincopal y presencia de fibras fascículo-ventriculares
| Autor: | Iciar Eizmendi, Luis Mont, Josep Brugada, Luis Aguinaga, Laura Guillamón, Ignacio Anguera, José Juan Alemán Sánchez, Mariona Matas, Mariana Valentino |
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| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test Radiofrequency ablation business.industry medicine.medical_treatment Atrial fibrillation Catheter ablation Accessory pathway Ablation medicine.disease law.invention law Internal medicine Ventricular fibrillation cardiovascular system medicine Cardiology In patient cardiovascular diseases Cardiology and Cardiovascular Medicine business Electrocardiography |
| Zdroj: | Revista Española de Cardiología. 51:591-595 |
| ISSN: | 0300-8932 |
| DOI: | 10.1016/s0300-8932(98)74793-1 |
| Popis: | Multiple accessory pathways in patients with the Wolff-Parkinson-White syndrome are infrequent and are associated with a higher risk of ventricular fibrillation. We present an exceptional case of a patient with four accessory pathways with anterograde conduction and a fasciculo-ventricular fiber in whom we performed a radiofrequency ablation. A 20 year old healthy male patient was seen at the emergency room after suffering syncope. The electrocardiogram showed atrial fibrillation with wide QRS complex suggestive of preexcitation. The electrophysiologic study demonstrated the presence of four atrio-ventricular accessory pathways with antegrade conduction (left lateral, right posteroseptal, right midseptal and right posterolateral). After ablation of the fourth accessory pathway, the electrocardiogram showed a persistent delta wave with a short HV interval. Atrial stimulation demonstrated decremental conduction, progressive lengthening of the AH interval and no modification in the HV interval nor in the preexcitation pattern, suggestive of the presence of a fasciculo-ventricular fiber. This exceptional case report is demonstrative of the complexity of the Wolff-Parkinson-White syndrome, and the feasibility and efficacy of radiofrequency catheter ablation in a single procedure. |
| Databáze: | OpenAIRE |
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