Radiofrequency Catheter Ablation of an Atriofascicular Pathway During Atrial Fibrillation: A Case Report

JOHN M. MILLER, GLENN R. HARPER, STEVEN A. ROTHMAN, HENRY H. HSIA

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Atriofascicular Ablation During Fibrillation. Introduction: A male patient with an atriofascicular pathway underwent catheter ablation of the atriofascicular pathway during atrial fibrillation. Methods and Results: The patient had preexcited atrial fibrillation both clinically and repeatedly during electrophysioiogic study. A preexcited tachycardia with a 1:1 AV relationship and regular RR intervals was also induced. Catheter ablation of the atriofascicular pathway could only be performed during persistent atrial fibrillation, based on mapping of the pathway's insertion into the right bundle branch. Following successful ablation and cardioversion to sinus rhythm, a regular QRS tachycardia (atrioventricular [AV] nodal reentry) having (he same rate, atrial activation sequence, and His‐atrial time as the regular preexcited tachycardia noted preablation was initiated. An AV nodal slow pathway modification eliminated this tachycardia. Neither atrial fibrillation nor AV nodal reentry has recurred on follow‐up. Conclusion: This is the first report of atriofascicular mapping and ablation performed exclusively during atrial fibrillation and illustrates the utility of mapping the pathway's ventricular insertion. Other unusual features (“bystander” pathway activation during AV nodal reentry, possible role of the pathway in genesis of atrial fibrillation) are discussed.

Original languageEnglish (US)
Pages (from-to)846-853
Number of pages8
JournalJournal of cardiovascular electrophysiology
Volume5
Issue number10
DOIs
StatePublished - Oct 1994
Externally publishedYes

Keywords

  • Mahaim fibers
  • atriofascicular ablation
  • supraventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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