Left-sided atrioventricular nodal ablation using the transseptal approach: clinico-histopathologic correlation.
To our knowledge, prograde access to the left ventricle to perform a left-sided AV node (AVN) ablation has not been reported. We present the case of a patient with Noonan's syndrome and supravalve aortic stenosis who required aortic valve replacement with a mechanical valve. Due to chronic atrial fibrillation, a transvenous pacing system was implanted and transcatheter radiofrequency ablation of the AVN was performed. Attempts at right-sided AVN ablation were unsuccessful. Due to the presence of the mechanical aortic valve, a left-sided AVN ablation was performed successfully using the transseptal approach. The patient died suddenly 6 months after the procedure, and the histologic study of the heart is reported.
Texas Children's Hospital, Baylor College of Medicine, Houston 77030, USA.
A L
AL
Fenrich
R A
RA
Friedman
F C
FC
Cecchin
D
D
Kearney
D000328:Adult; D001281:Atrial Fibrillation / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001283:Atrioventricular Node / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods; D017809:Fatal Outcome; D005500:Follow-Up Studies; D006339:Heart Rate; D006346:Heart Septum; D006801:Humans; D008297:Male; D013617:Tachycardia, Supraventricular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017180:Tachycardia, Ventricular / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*