Köse Sedat, Başarıcı Ibrahim, Kabul Kutsi Hasan, Barçın Cem
Department of Cardiology, Gülhane Military Medical School, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2011 Oct;39(7):579-83. doi: 10.5543/tkda.2011.01551.
In patients with Wolff-Parkinson-White syndrome, difficulty in ablation of accessory pathways is associated with failures and recurrences. Epicardially located accessory pathways may require different management strategies when conventional ablation attempts fail. In particular, an epicardial accessory pathway communicating the right atrial appendage to the right ventricle is an extraordinary situation resulting in difficulties in ablation. Hereby, we report on a challenging case of percutaneous epicardial ablation of an epicardial accessory pathway located at right atrial appendage in a 28-year-old man with Wolff-Parkinson-White syndrome, who had a prior history of unsuccessful endocardial ablation. Percutaneous epicardial ablation may be a viable option obviating the necessity of surgical ablation procedures for difficult ablation cases with epicardial accessory pathways.
在预激综合征患者中，附加通路消融困难与消融失败及复发相关。当传统消融尝试失败时，位于心外膜的附加通路可能需要不同的处理策略。特别是，连接右心耳与右心室的心外膜附加通路是一种特殊情况，会导致消融困难。在此，我们报告一例具有挑战性的病例，一名28岁患有预激综合征的男性，其右心耳处存在心外膜附加通路，既往心内膜消融失败，此次行经皮心外膜消融。对于有心外膜附加通路的困难消融病例，经皮心外膜消融可能是一种可行的选择，可避免手术消融程序。
