Multiple accessory pathways in the permanent form of junctional reciprocating tachycardia

Hue Teh Shih, William M. Miles, Lawrence S. Klein, Joyce E. Hubbard, Douglas P. Zipes

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

The permanent form of junctional reciprocating tachycardia (PJRT) has been successfully eliminated by ablation of the accessory pathway responsible for the tachycardia. The coexistence of multiple accessory pathways responsible for different, long RP-interval tachycardias was not documented previously. Five patients with PJRT underwent radiofrequency catheter ablation of accessory pathways. Three of 5 patients had 2 accessory pathways each: 1 had 2 left free wall accessory pathways, another had a right posterior free wall and right posteroseptal pathway, whereas the third had 2 right posteroseptal pathways approximately 1 cm apart. The remaining 2 patients each had 1 right posteroseptal accessory pathway. Seven of 8 pathways were successfully ablated with a median of 3 radiofrequency pulses. No patient developed complications. Peak serum creatine kinase ranged from 131 to 311 IU/liter, with peak MB fraction 7 to 17 IU/liter, or 5 to 11%. Follow-up electrophysiologic study, 29 to 70 days after ablation, revealed no inducible tachycardia and no evidence of accessory pathway conduction, except for the 1 pathway not ablated. All patients remained asymptomatic 17 to 29 months after ablation. Thus, patients with PJRT can have several accessory pathways that can be safely and effectively eliminated with radiofrequency catheter ablation.

Original languageEnglish
Pages (from-to)361-367
Number of pages7
JournalThe American Journal of Cardiology
Volume73
Issue number5
DOIs
StatePublished - Feb 15 1994

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Reciprocating Tachycardia
Tachycardia
Catheter Ablation
Creatine Kinase
Serum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Multiple accessory pathways in the permanent form of junctional reciprocating tachycardia. / Shih, Hue Teh; Miles, William M.; Klein, Lawrence S.; Hubbard, Joyce E.; Zipes, Douglas P.

In: The American Journal of Cardiology, Vol. 73, No. 5, 15.02.1994, p. 361-367.

Research output: Contribution to journalArticle

Shih, Hue Teh ; Miles, William M. ; Klein, Lawrence S. ; Hubbard, Joyce E. ; Zipes, Douglas P. / Multiple accessory pathways in the permanent form of junctional reciprocating tachycardia. In: The American Journal of Cardiology. 1994 ; Vol. 73, No. 5. pp. 361-367.
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