title: Closed chest catheter ablation of an accessory pathway in a patient with permanent junctional reciprocating tachycardia.
abstract: This report describes a 23 year old woman with a lifelong history of permanent junctional reciprocating tachycardia refractory to conventional antiarrhythmic medications who was successfully treated with closed chest, transvenous selective ablation of a posteroseptal bypass tract. Two 100 J (stored) direct-current shocks were delivered to the region of the os of the coronary sinus using a quadripolar catheter positioned in the coronary sinus. At a 2 month follow-up interval, the patient is asymptomatic without recurrence of the tachycardia. It is concluded that in patients with permanent junctional reciprocating tachycardia, selective catheter ablation of a posteroseptal accessory pathway is a feasible alternative to a difficult pharmacologic regimen or to ablative surgery.
mesh_terms: D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology; D002036:Bundle of His / Q000503:physiopathology; D006328:Cardiac Catheterization; D004599:Electric Stimulation Therapy / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D013610:Tachycardia / Q000503:physiopathology / Q000628:therapy*