Cryoablation of two accessory pathways in a single session: appraisal of a direct cryoablation approach in right septal locations.

摘要

A 37-year-old woman with Wolff-Parkinson-White syndrome had experienced atrioventric-ular re-entrant tachycardias for 3 years. The standard ECG showed a shortened PQinterval, a positive delta wave in leads I, II and aVF and a negative delta wave in V1, suggesting a parahisian AP location (Fig. 1A). A first electrophysiological procedure confirmed this location with the earliest ventricular activation during antegrade conduction recorded in the His-bundle area anteriorly on the His-bundle catheter. The patient was treated with antiarrhythmic drug therapy, but after several months, she remained symptomatic, so a second electrophysiological study was performed, confirming the parahisian location.