title: Radiofrequency ablation of atrioventricular accessory pathways associated with discordant atrioventricular connections.
abstract: Discordant atrioventricular connections associated with Wolff-Parkinson-White syndrome increase the challenge of radiofrequency ablation. We report the results and techniques of radiofrequency ablation in three patients with discordant atrioventricular connections, including one patient having double outlet right ventricle with atrioventricular reentry tachycardias. There were two males and one female, aged 14 and 22 years old. We found four accessory pathways during our electrophysiological studies, with two of them manifest on the electrocardiogram, corresponding to left paraseptal and right midseptal regions. The electrophysiological study confirmed this localization, and showed two concealed accessory pathways in the right and left paraseptal regions. Radiofrequency ablation was successful in all cases without recurrence at a mean follow-up of 18.6 months. No complications were observed during the procedures. We conclude that radiofrequency ablation is feasible and effective in the ablation of accessory pathways in patients with discordant atrioventricular connections.
authors.affiliation: Department of Electrophysiology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico. pedroi@yahoo.com
authors.forename: Pedro
authors.initials: P
authors.lastname: Iturralde
authors.forename: Leonardo
authors.initials: L
authors.lastname: Rivera-Rodríguez
authors.forename: Milton E
authors.initials: ME
authors.lastname: Guevara-Valdivia
authors.forename: Luis
authors.initials: L
authors.lastname: Colín
authors.forename: Manlio F
authors.initials: MF
authors.lastname: Márquez
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Calvimontes
mesh_terms: D000055:Accessory Nerve / Q000473:pathology* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001283:Atrioventricular Node / Q000473:pathology* / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008800:Mexico; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000601:surgery; D016896:Treatment Outcome; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000601:surgery