Characteristics of intracardiac potentials at successful ablation sites in concealed Wolff-Parkinson-White syndrome.
The authors investigated bipolar electrograms recorded from the catheter tip at the actual successful ablation sites in 22 consecutive patients with concealed Wolff-Parkinson-White syndrome to clarify the characteristics of the potentials indicating the optimal site for catheter ablation. In all patients the retrograde transaortic approach to their left-sided accessory pathways, and a temperature-controlled (60 degrees C) energy delivery, were performed. The authors assumed that a shorter dissociation time (time from energy delivery to ventriculoatrial conduction dissociation) indicated more accurate catheter mapping. A significant negative correlation (r = 0.527, p < 0.05) between the AV ratio (ratio of the amplitudes of the atrial to ventricular potentials) recorded at the ablation catheter tip and the dissociation time was observed. When the AV ratio and the dissociation time were compared among the groups classified according to the corresponding Npeak (the number of positive potential peaks in the electrogram obtained from the ablation catheter tip during right ventricular apical pacing) value, they differed significantly (p < 0.05 and p < 0.01, respectively), ie, a higher AV ratio and a shorter dissociation time related to a multipeak electrogram from the ablation catheter tip. The authors conclude that the atrial insertion site of the accessory pathway, exhibiting a multipeak complex electrogram that may represent nonuniform anisotropic characteristics, is an adequate ablation site.
Kawamura
Y
Y
First Department of Internal Medicine, Asahikawa Medical College, Japan.
Sato
N
N
Sakamoto
N
N
Yokoyama
A
A
Kamada
S
S
Kakuchi
H
H
Iida
Y
Y
Kikuchi
K
K
D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology* / Q000601:surgery