Paraseptal accessory pathway in Wolff-Parkinson- White-Syndrom: ablation from the right, from the left or within the coronary sinus/middle cardiac vein?

Kobza, Richard; Hindricks, Gerhard; Tanner, Hildegard; Piorkowski, Christopher; Wetzel, Ulrike; Schirdewahn, Petra; Dorszewski, Anja; Gerds-Li, Jin-Hong; Kottkamp, Hans (2005). Paraseptal accessory pathway in Wolff-Parkinson- White-Syndrom: ablation from the right, from the left or within the coronary sinus/middle cardiac vein? Journal of interventional cardiac electrophysiology, 12(1), pp. 55-60. Springer 10.1007/s10840-005-5841-2

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AIMS In 1999 the consensus statement "living anatomy of the atrioventricular junctions" was published. With that new nomenclature the former posteroseptal accessory pathway (APs) are termed paraseptal APs. The aim of this study was to identify ECG features of manifest APs located in this complex paraseptal space. METHODS AND RESULTS ECG characteristics of all patients who underwent radiofrequency ablation of an AP during a 3 year period were analyzed. Of the 239 patients with one or more APs, 30 patients had a paraseptal AP with preexcitation. Compared to APs within the coronary sinus (CS) or the middle cardiac vein (MCV) the right sided paraseptal APs significantly more often showed an isoelectric delta wave in lead II and/or a negative delta wave in aVR. The left sided paraseptal APs presented a negative delta wave in II significantly more often compared to the right sided APs. CONCLUSIONS According to the site of radiofrequency ablation, paraseptal APs are classified into 4 subgroups: paraseptal right, paraseptal left, inside the CS or inside the MCV. Subtle differences in preexcitation patterns of the delta wave as well as of the QRS complex exist. However, the definitive localization of APs remains reserved to the periinterventional intracardiac electrogram analysis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Tanner, Hildegard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1383-875X

Publisher:

Springer

Language:

English

Submitter:

Hildegard Tanner

Date Deposited:

20 Jun 2014 16:10

Last Modified:

20 Jun 2014 16:10

Publisher DOI:

10.1007/s10840-005-5841-2

PubMed ID:

15717152

URI:

https://boris.unibe.ch/id/eprint/42316

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