Yonsei Med J.  2007 Dec;48(6):1048-1051. 10.3349/ymj.2007.48.6.1048.

Catheter Ablation of a Left Free-Wall Accessory Pathway via the Radial Artery Approach

• Lee DW
• Kim J
• Lee HC
• Kim JH
• Chun KJ
• Hong TJ
• Shin YW

• KMID: 1786224
• DOI: http://doi.org/10.3349/ymj.2007.48.6.1048

Abstract

Catheter ablation of the left free-wall accessory pathways (APs) is normally performed by the retrograde transaortic approach via a femoral artery or the transseptal approach. Here we report a case of an overt left free-wall AP, which was successfully ablated with a retrograde transaortic approach via the radial artery without any vascular complications. The patient has remained free of any symptoms or pre-excitation observed on the ECG during a 10-month post- ablation follow-up.

Keyword

Catheter ablation; pre-excitation; radial artery

MeSH Terms

Adult
Catheter Ablation/*methods
Electrocardiography
Humans
Male
Tachycardia, Supraventricular/complications/physiopathology/*therapy
Treatment Outcome
Wolff-Parkinson-White Syndrome/complications/pathology

Figure

• 

  Fig. 1 12-lead ECGs during sinus rhythm (A), rapid atrial pacing (B), and an induced supraventricular tachycardia (C).

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  Fig. 2 Surface lead electrocardiograms and intracardiac electrograms during the baseline (A), ventricular pacing at a cycle length of 320 ms (B) and a supraventricular tachycardia (C). ECG leads I, aVF, and V1 are displayed together with the electrograms from the high right atrium (HRA), proximal to distal His bundle (His), proximal to distal coronary sinus (CS), and right ventricular apex (RVA) catheters.

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  Fig. 3 Intracardiac electrograms (A) and 40° left anterior oblique fluoroscopic view from the ablation site (B). (A) The local electrogram recorded from the mapping catheter (MAP) exhibited a tri-phasic fused atrio-ventricular electrogram with a possible accessory pathway potential, and the unipolar electrogram recorded from the MAP (MAPuni) revealed a QS pattern. (B), (C) The ablation catheter was passed over the left subclavian artery (arrow) and positioned on the mitral annulus.

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