title: [Initial presentation of ventricular pre-excitation after catheter ablation of concealed retrograde conducting accessory atrioventricular pathways].
abstract: Catheter ablation using radiofrequency or direct current energy was performed in 19 consecutive patients with concealed accessory pathways. Four patients developed manifest preexcitation for the first time following ablation. The concealed accessory pathways of these four patients were localized at right lateral, left posteroseptal, left posterolateral, and left lateral sites, respectively. In two patients, manifest preexcitation developed immediately after attempted ablation. In the other two patients, preexcitation occurred after 4 and 14 days. Electrophysiologic testing revealed in all four patients that the origin of manifest preexcitation corresponded to the site of the concealed pathway. Successful catheter ablation using radiofrequency current was performed in three patients. One patient preferred surgical interruption of the accessory pathway. The reason for this sudden emergence of preexcitation of these patients with only retrograde conducting pathways remains to be investigated. The anterograde conduction capacity might have been modified by damaging the site of the accessory pathway insertion.
authors.affiliation: Medizinische Klinik und Poliklinik (Kardiologie/Angiologie), Westfälische Wilhelms-Universität Münster.
authors.forename: S
authors.initials: S
authors.lastname: Willems
authors.forename: M
authors.initials: M
authors.lastname: Borggrefe
authors.forename: M
authors.initials: M
authors.lastname: Shenasa
authors.forename: G
authors.initials: G
authors.lastname: Hindricks
authors.forename: W
authors.initials: W
authors.lastname: Haverkamp
authors.forename: X
authors.initials: X
authors.lastname: Chen
authors.forename: K
authors.initials: K
authors.lastname: Seidl
authors.forename: G
authors.initials: G
authors.lastname: Breithardt
mesh_terms: D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery*; D002036:Bundle of His / Q000503:physiopathology / Q000601:surgery; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D011226:Pre-Excitation Syndromes / Q000209:etiology* / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000503:physiopathology / Q000601:surgery*; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology / Q000601:surgery*
vernacular_title: Erstmaliges Auftreten ventrikulärer Präexzitation nach Katheterablation ausschliesslich retrograd leitender akzessorischer atrioventrikulärer Bahnen.