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Slow and wide QRS complex tachycardia as a unique complication following radiofrequency catheter ablation of a left-sided accessory pathway in a child

Published online by Cambridge University Press:  03 May 2005

Radu Vatasescu
Affiliation:
Hungarian Institute of Cardiology, Budapest, Hungary
Laszlo Kornyei
Affiliation:
Hungarian Institute of Cardiology, Budapest, Hungary
Tamas Szili-Torok
Affiliation:
Hungarian Institute of Cardiology, Budapest, Hungary

Abstract

Radiofrequency lesions can, theoretically, be the substrate for new persistent arrhythmias. As far as we know, this has never previously been encountered after transcatheter ablation of accessory pathways. A child with Wolff–Parkinson–White syndrome was referred for radiofrequency catheter ablation of a left-sided accessory pathway. After successful ablation of the accessory pathway using a retrograde transaortic approach, the child developed an incessant wide QRS complex tachycardia at slow rate that was resistant to pharmacologic interventions. The focus of the tachycardia was identical to the ventricular site of insertion of the eliminated accessory pathway.

Type
Brief Report
Copyright
© 2005 Cambridge University Press

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References

Hindricks G. The Multicentre European Radiofrequency Survey (MERFS): complication of radiofrequency catheter ablation of arrhythmia. The Multicentre European Radiofrequency Survey (MERFS) investigators of the Working Group on Arrhythmias of the European Society of Cardiology. Eur Heart J 1993; 14: 16441653.Google Scholar
Scheinman MM, Huang S. The 1998 NASPE prospective catheter ablation registry. Pacing Clin Electrophysiol 2000; 23: 10201028.Google Scholar
Kugler JD, Danford DA, Houston K, et al. Pediatric Radiofrequency Catheter Ablation Registry: Update of immediate results. In: Imai Y, Momma K (eds). Proceedings of the Second World Congress of Pediatric Cardiology and Cardiac Surgery. Futura, Armonk, NY, 1998, pp 604605.
Aytemir K, Amasyali B, Kose S, et al. Maximum p-wave duration and p-wave dispersion predict recurrence of paroxysmal atrial fibrillation in patients with Wolff–Parkinson–White syndrome after successful radiofrequency catheter ablation. J Interv Card Electrophysiol 2004; 11: 2127.Google Scholar
Oddsson H, Walfridsson H, Edvardsson N. Perception and documentation of arrhythmias after successful radiofrequency catheter ablation of accessory pathways. Ann Noninvasive Electrocardiol 2001; 6: 216221.Google Scholar
Deam AG, Burton E, Walter P, Langberg JJ. Wide complex tachycardia due to automaticity in an accessory pathway. PACE 1995; 18: 21062108.Google Scholar
Tseng ZH, Yadav AV, Scheinman MM. Catecholamine dependent accessory pathway automaticity. PACE 2004; 27: 10051007.Google Scholar
Macle L, Shah DC, Jais P, Haissaguerre M. Accessory pathway automaticity after radiofrequency ablation. J Cardiovasc Electrophysiol 2002; 13: 285287.Google Scholar
Josephson ME, Almendral JM, Buxton AE, Marchlinsky FE. Mechanisms of ventricular tachycardia. Circulation 1987; 75: III41III47.Google Scholar