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Delayed radiofrequency ablation efficacy in slow pathway ablation: a case report.


ABSTRACT:

Background

The delayed effect of radiofrequency (RF) ablation was described in cases of accessory pathway and premature ventricular contraction ablation, as well as delayed atrioventricular (AV) block after slow pathway ablation.

Case summary

We report a case of a female patient with AV nodal re-entry tachycardia (AVNRT), in whom the first electrophysiology study ended with acute failure of slow pathway ablation, despite using long steerable sheath, both right and left-sided ablation with >15?min of RF energy application and repeatedly achieving junctional rhythm. Six weeks afterwards, during scheduled three-dimensional electroanatomical mapping procedure, there was no proof of dual AV nodal conduction nor could the tachycardia be induced. Also, the patient did not have palpitations between the two procedures nor during the 12-month follow-up period.

Discussion

This case illustrates that watchful waiting for delayed RF ablation efficacy in some cases of AVNRT ablation could be reasonable, in order to reduce the risk of complications associated with slow pathway ablation.

SUBMITTER: Zeljkovic I 

PROVIDER: S-EPMC7859601 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Delayed radiofrequency ablation efficacy in slow pathway ablation: a case report.

Zeljković Ivan I   Pavlović Nikola N   Radeljić Vjekoslav V   Manola Šime Š  

European heart journal. Case reports 20210204 2


<h4>Background</h4>The delayed effect of radiofrequency (RF) ablation was described in cases of accessory pathway and premature ventricular contraction ablation, as well as delayed atrioventricular (AV) block after slow pathway ablation.<h4>Case summary</h4>We report a case of a female patient with AV nodal re-entry tachycardia (AVNRT), in whom the first electrophysiology study ended with acute failure of slow pathway ablation, despite using long steerable sheath, both right and left-sided ablat  ...[more]

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