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Turakhia MP, Scheinman M, Badhwar N. Wolff-Parkinson-White syndrome: where is the pathway?. Indian Pacing Electrophysiol J. 2009;9(2):130-3
Turakhia, M. P., Scheinman, M., & Badhwar, N. (2009). Wolff-Parkinson-White syndrome: where is the pathway?. Indian pacing and electrophysiology journal, 9(2), 130-3.
Turakhia, Mintu P, et al. "Wolff-Parkinson-White syndrome: where is the pathway?." Indian pacing and electrophysiology journal vol. 9,2 (2009): 130-3.
Turakhia MP, Scheinman M, Badhwar N. Wolff-Parkinson-White syndrome: where is the pathway?. Indian Pacing Electrophysiol J. 2009;9(2):130-3. Epub 2009 Mar 15. PMID: 19308285; PMCID: PMC2655076.
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Indian Pacing Electrophysiol J. 2009;9(2):130-3. Epub 2009 Mar 15.

Wolff-Parkinson-White syndrome: where is the pathway?.

Indian pacing and electrophysiology journal

Mintu P Turakhia, Melvin Scheinman, Nitish Badhwar

Affiliations

  1. Electrophysiology Section, Department of Medicine, Stanford University. [email protected]

PMID: 19308285 PMCID: PMC2655076

Abstract

A 31-year old male presented with atrial fibrillation and ventricular preexcitation that was positive in leads V1-V4, negative in lead II, and positive in lead AVR. The patient was cardioverted and invasive electrophysiologic study was performed. Based on the ECG findings, the coronary sinus and its branches were interrogated during orthodromic atrioventricular reentrant tachycardia. The earliest local activation was seen in the true coronary sinus lumen at the bifurcation of the posterolateral branch. Radiofrequency energy application at this area led to loss of preexcitation. When localizing left septal and posterior accessory pathways, ventricular preexcitation that is both negative in II and positive in AVR has been shown in previous studies to be highly sensitive and specific for a subepicardial location. Therefore, investigation of the coronary sinus and its branches may allow for effective ablation without the need for left ventricular access.

Keywords: Wolff-Parkinson-White; ablation; accessory pathway; coronary sinus ablation; pre-excitation

References

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