Unexpected Emergence of Manifest Preexcitation Following Transcatheter Ablation of Concealed Accessory Pathways
Identifieur interne : 002929 ( Main/Corpus ); précédent : 002928; suivant : 002930Unexpected Emergence of Manifest Preexcitation Following Transcatheter Ablation of Concealed Accessory Pathways
Auteurs : Stephan Willems ; Mohammad Shenasa ; Martin Borggrefe ; Karlheinz Seidl ; Xu Chen ; Gerhard Hindricks ; Wilhelm Haverkamp ; Günter BreithardtSource :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 1993-08.
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- KwdEn :
Abstract
Preexcitation After Catheter Ablation. Introduction: The basis for anterograde or retrograde unidirectional block of accessory pathways still remains a controversial issue. Methods and Results: Four of 19 consecutive patients (1 mule, 3 Female; ages 27 to 34 years) who underwent transcatheter ablation of concealed accessory pathways developed manifest preexcitation after the ablation. The location of the concealed accessory pathways in these four patients were right lateral, left posteroseptal, left posterolateral, and left lateral. Radiofrequency current was used in three of the four patients and high energy direct current in one patient. After ablation, manifest preexcitation was observed in these four patients for the first time. Manifest preexcitation developed immediately after ablation in two of the four patients and after 4 and 14 days in the other two. Detailed endocardial mapping revealed that the manifest preexcitation originated from the same location as the concealed pathways. Subsequently, catheter ablation was successfully performed in three of the four patients using radiofrequency current. One patient underwent successful surgical ablation. No recurrence of preexcitation was observed during a follow‐up period of 9 to 38 months. All patients remained free of arrhythmias. Conclusion: The basis for this unexpected emergence of preexcitation in these patients with only retrograde conducting accessory pathways deserves further investigation. Although not compared in the present study, this phenomenon has not been reported in patients who underwent surgical interruption of accessory pathways. We postulate that a lesion at the site of insertion of the accessory pathway had modified the anterograde conduction capacity.
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DOI: 10.1111/j.1540-8167.1993.tb01284.x
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last="Borggrefe">Martin Borggrefe</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Seidl, Karlheinz" sort="Seidl, Karlheinz" uniqKey="Seidl K" first="Karlheinz" last="Seidl">Karlheinz Seidl</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Chen, Xu" sort="Chen, Xu" uniqKey="Chen X" first="Xu" last="Chen">Xu Chen</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hindricks, Gerhard" sort="Hindricks, Gerhard" uniqKey="Hindricks G" first="Gerhard" last="Hindricks">Gerhard Hindricks</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Haverkamp, Wilhelm" sort="Haverkamp, Wilhelm" uniqKey="Haverkamp W" first="Wilhelm" last="Haverkamp">Wilhelm Haverkamp</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Breithardt, Gunter" sort="Breithardt, Gunter" uniqKey="Breithardt G" first="Günter" last="Breithardt">Günter Breithardt</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno 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Shenasa</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Borggrefe, Martin" sort="Borggrefe, Martin" uniqKey="Borggrefe M" first="Martin" last="Borggrefe">Martin Borggrefe</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Seidl, Karlheinz" sort="Seidl, Karlheinz" uniqKey="Seidl K" first="Karlheinz" last="Seidl">Karlheinz Seidl</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Chen, Xu" sort="Chen, Xu" uniqKey="Chen X" first="Xu" last="Chen">Xu Chen</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hindricks, Gerhard" sort="Hindricks, Gerhard" uniqKey="Hindricks G" first="Gerhard" last="Hindricks">Gerhard Hindricks</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Haverkamp, Wilhelm" sort="Haverkamp, Wilhelm" uniqKey="Haverkamp W" first="Wilhelm" last="Haverkamp">Wilhelm Haverkamp</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author><author><name sortKey="Breithardt, Gunter" sort="Breithardt, Gunter" uniqKey="Breithardt G" first="Günter" last="Breithardt">Günter Breithardt</name><affiliation><mods:affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1993-08">1993-08</date><biblScope unit="volume">4</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="467">467</biblScope><biblScope unit="page" to="472">472</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">E08A1D72BFFE1B48D367B8D776D96FC8261D6DA4</idno><idno type="DOI">10.1111/j.1540-8167.1993.tb01284.x</idno><idno type="ArticleID">JCE467</idno></biblStruct></sourceDesc><seriesStmt><idno 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Introduction: The basis for anterograde or retrograde unidirectional block of accessory pathways still remains a controversial issue. Methods and Results: Four of 19 consecutive patients (1 mule, 3 Female; ages 27 to 34 years) who underwent transcatheter ablation of concealed accessory pathways developed manifest preexcitation after the ablation. The location of the concealed accessory pathways in these four patients were right lateral, left posteroseptal, left posterolateral, and left lateral. Radiofrequency current was used in three of the four patients and high energy direct current in one patient. After ablation, manifest preexcitation was observed in these four patients for the first time. Manifest preexcitation developed immediately after ablation in two of the four patients and after 4 and 14 days in the other two. Detailed endocardial mapping revealed that the manifest preexcitation originated from the same location as the concealed pathways. Subsequently, catheter ablation was successfully performed in three of the four patients using radiofrequency current. One patient underwent successful surgical ablation. No recurrence of preexcitation was observed during a follow‐up period of 9 to 38 months. All patients remained free of arrhythmias. Conclusion: The basis for this unexpected emergence of preexcitation in these patients with only retrograde conducting accessory pathways deserves further investigation. Although not compared in the present study, this phenomenon has not been reported in patients who underwent surgical interruption of accessory pathways. We postulate that a lesion at the site of insertion of the accessory pathway had modified the anterograde conduction capacity.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>STEPHAN WILLEMS M.D.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>MOHAMMAD SHENASA M.D., F.E.S.C., F.A.C.C.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>MARTIN BORGGREFE M.D.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>KARLHEINZ SEIDL M.D.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>XU CHEN M.D.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>GERHARD HINDRICKS M.D.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>WILHELM HAVERKAMP M.D.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item><json:item><name>GÜNTER BREITHARDT M.D., F.E.S.C., F.A.C.C.</name><affiliations><json:string>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>accessory pathway</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>catheter ablation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ventricular preexcitation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>concealed accessory pathway</value></json:item></subject><articleId><json:string>JCE467</json:string></articleId><language><json:string>eng</json:string></language><abstract>Preexcitation After Catheter Ablation. Introduction: The basis for anterograde or retrograde unidirectional block of accessory pathways still remains a controversial issue. Methods and Results: Four of 19 consecutive patients (1 mule, 3 Female; ages 27 to 34 years) who underwent transcatheter ablation of concealed accessory pathways developed manifest preexcitation after the ablation. The location of the concealed accessory pathways in these four patients were right lateral, left posteroseptal, left posterolateral, and left lateral. Radiofrequency current was used in three of the four patients and high energy direct current in one patient. After ablation, manifest preexcitation was observed in these four patients for the first time. Manifest preexcitation developed immediately after ablation in two of the four patients and after 4 and 14 days in the other two. Detailed endocardial mapping revealed that the manifest preexcitation originated from the same location as the concealed pathways. Subsequently, catheter ablation was successfully performed in three of the four patients using radiofrequency current. One patient underwent successful surgical ablation. No recurrence of preexcitation was observed during a follow‐up period of 9 to 38 months. All patients remained free of arrhythmias. Conclusion: The basis for this unexpected emergence of preexcitation in these patients with only retrograde conducting accessory pathways deserves further investigation. Although not compared in the present study, this phenomenon has not been reported in patients who underwent surgical interruption of accessory pathways. We postulate that a lesion at the site of insertion of the accessory pathway had modified the anterograde conduction capacity.</abstract><qualityIndicators><score>6.796</score><pdfVersion>1.6</pdfVersion><pdfPageSize>530 x 750 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1756</abstractCharCount><pdfWordCount>2308</pdfWordCount><pdfCharCount>16072</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>249</abstractWordCount></qualityIndicators><title>Unexpected Emergence of Manifest Preexcitation Following Transcatheter Ablation of Concealed Accessory 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Münster, Germany</affiliation></author><author><persName><forename type="first">MARTIN</forename><surname>BORGGREFE</surname></persName><roleName type="degree">M.D.</roleName><note type="correspondence"><p>Correspondence: Martin Borggrefe, M.D., Westfälische Wilhelms‐Universität Minister, Medizinische Klinik und Poliklinik, Innere Medizin C, Alhert‐Schweitzer‐Str, 33, D‐4400 Münster, Germany, Fax: 44‐111‐82145.</p></note><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation></author><author><persName><forename type="first">KARLHEINZ</forename><surname>SEIDL</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation></author><author><persName><forename type="first">XU</forename><surname>CHEN</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation></author><author><persName><forename type="first">GERHARD</forename><surname>HINDRICKS</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation></author><author><persName><forename type="first">WILHELM</forename><surname>HAVERKAMP</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation></author><author><persName><forename type="first">GÜNTER</forename><surname>BREITHARDT</surname></persName><roleName type="degree">M.D., F.E.S.C., F.A.C.C.</roleName><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische 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Introduction: The basis for anterograde or retrograde unidirectional block of accessory pathways still remains a controversial issue. Methods and Results: Four of 19 consecutive patients (1 mule, 3 Female; ages 27 to 34 years) who underwent transcatheter ablation of concealed accessory pathways developed manifest preexcitation after the ablation. The location of the concealed accessory pathways in these four patients were right lateral, left posteroseptal, left posterolateral, and left lateral. Radiofrequency current was used in three of the four patients and high energy direct current in one patient. After ablation, manifest preexcitation was observed in these four patients for the first time. Manifest preexcitation developed immediately after ablation in two of the four patients and after 4 and 14 days in the other two. Detailed endocardial mapping revealed that the manifest preexcitation originated from the same location as the concealed pathways. Subsequently, catheter ablation was successfully performed in three of the four patients using radiofrequency current. One patient underwent successful surgical ablation. No recurrence of preexcitation was observed during a follow‐up period of 9 to 38 months. All patients remained free of arrhythmias. Conclusion: The basis for this unexpected emergence of preexcitation in these patients with only retrograde conducting accessory pathways deserves further investigation. Although not compared in the present study, this phenomenon has not been reported in patients who underwent surgical interruption of accessory pathways. We postulate that a lesion at the site of insertion of the accessory pathway had modified the anterograde conduction capacity.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>accessory pathway</term></item><item><term>catheter ablation</term></item><item><term>ventricular preexcitation</term></item><item><term>concealed accessory pathway</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1993-08">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/E08A1D72BFFE1B48D367B8D776D96FC8261D6DA4/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8167</doi><issn type="print">1045-3873</issn><issn type="electronic">1540-8167</issn><idGroup><id type="product" value="JCE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY">Journal of Cardiovascular Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="08004"><doi origin="wiley">10.1111/jce.1993.4.issue-4</doi><numberingGroup><numbering type="journalVolume" number="4">4</numbering><numbering type="journalIssue" number="4">4</numbering></numberingGroup><coverDate startDate="1993-08">August 1993</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0046700" status="forIssue"><doi origin="wiley">10.1111/j.1540-8167.1993.tb01284.x</doi><idGroup><id type="unit" value="JCE467"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title><title type="tocHeading2"><!--WileyML 3Gv2 convertor changed from tocHeading1 to tocHeading2-->Case Reports</title></titleGroup><eventGroup><event type="firstOnline" date="2007-04-29"></event><event type="publishedOnlineFinalForm" date="2007-04-29"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:HeaderRef result:HeaderRef" date="2010-03-10"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-29"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-24"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="467">467</numbering><numbering type="pageLast" number="472">472</numbering></numberingGroup><correspondenceTo>Martin Borggrefe, M.D., Westfälische Wilhelms‐Universität Minister, Medizinische Klinik und Poliklinik, Innere Medizin C, Alhert‐Schweitzer‐Str, 33, D‐4400 Münster, Germany, Fax: 44‐111‐82145.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JCE.JCE467.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Manuscript received 24 August 1992; Accepted for publication IS December 1992</unparsedEditorialHistory><countGroup><count type="referenceTotal" number="13"></count><count type="linksCrossRef" number="9"></count></countGroup><titleGroup><title type="main">Unexpected Emergence of Manifest Preexcitation Following Transcatheter Ablation of Concealed Accessory Pathways</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>STEPHAN</givenNames><familyName>WILLEMS</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>MOHAMMAD</givenNames><familyName>SHENASA</familyName><degrees>M.D., F.E.S.C., F.A.C.C.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1" corresponding="yes"><personName><givenNames>MARTIN</givenNames><familyName>BORGGREFE</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>KARLHEINZ</givenNames><familyName>SEIDL</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>XU</givenNames><familyName>CHEN</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>GERHARD</givenNames><familyName>HINDRICKS</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1"><personName><givenNames>WILHELM</givenNames><familyName>HAVERKAMP</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>GÜNTER</givenNames><familyName>BREITHARDT</familyName><degrees>M.D., F.E.S.C., F.A.C.C.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="DE"><unparsedAffiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">accessory pathway</keyword><keyword xml:id="k2">catheter ablation</keyword><keyword xml:id="k3">ventricular preexcitation</keyword><keyword xml:id="k4">concealed accessory pathway</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Preexcitation After Catheter Ablation. <i>Introduction:</i> The basis for anterograde or retrograde unidirectional block of accessory pathways still remains a controversial issue.</p><p> <i>Methods and Results:</i> Four of 19 consecutive patients (1 mule, 3 Female; ages 27 to 34 years) who underwent transcatheter ablation of concealed accessory pathways developed manifest preexcitation after the ablation. The location of the concealed accessory pathways in these four patients were right lateral, left posteroseptal, left posterolateral, and left lateral. Radiofrequency current was used in three of the four patients and high energy direct current in one patient. After ablation, manifest preexcitation was observed in these four patients for the first time. Manifest preexcitation developed immediately after ablation in two of the four patients and after 4 and 14 days in the other two. Detailed endocardial mapping revealed that the manifest preexcitation originated from the same location as the concealed pathways. Subsequently, catheter ablation was successfully performed in three of the four patients using radiofrequency current. One patient underwent successful surgical ablation. No recurrence of preexcitation was observed during a follow‐up period of 9 to 38 months. All patients remained free of arrhythmias.</p><p> <i>Conclusion:</i> The basis for this unexpected emergence of preexcitation in these patients with only retrograde conducting accessory pathways deserves further investigation. Although not compared in the present study, this phenomenon has not been reported in patients who underwent surgical interruption of accessory pathways. We postulate that a lesion at the site of insertion of the accessory pathway had modified the anterograde conduction capacity.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="n-fnt-1" numbered="no"><p>Presented as an abstract at the 44th session of the American College of cardiology, Dallas, Texas, 1992.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Unexpected Emergence of Manifest Preexcitation Following Transcatheter Ablation of Concealed Accessory Pathways</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Unexpected Emergence of Manifest Preexcitation Following Transcatheter Ablation of Concealed Accessory Pathways</title></titleInfo><name type="personal"><namePart type="given">STEPHAN</namePart><namePart type="family">WILLEMS</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MOHAMMAD</namePart><namePart type="family">SHENASA</namePart><namePart type="termsOfAddress">M.D., F.E.S.C., F.A.C.C.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">MARTIN</namePart><namePart type="family">BORGGREFE</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><description>Correspondence: Martin Borggrefe, M.D., Westfälische Wilhelms‐Universität Minister, Medizinische Klinik und Poliklinik, Innere Medizin C, Alhert‐Schweitzer‐Str, 33, D‐4400 Münster, Germany, Fax: 44‐111‐82145.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">KARLHEINZ</namePart><namePart type="family">SEIDL</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">XU</namePart><namePart type="family">CHEN</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">GERHARD</namePart><namePart type="family">HINDRICKS</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">WILHELM</namePart><namePart type="family">HAVERKAMP</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">GÜNTER</namePart><namePart type="family">BREITHARDT</namePart><namePart type="termsOfAddress">M.D., F.E.S.C., F.A.C.C.</namePart><affiliation>Department of Cardiology and Angiology, Hospital of the Westfalische Wilhelms‐University of Münster, Münster, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1993-08</dateIssued><edition>Manuscript received 24 August 1992; Accepted for publication IS December 1992</edition><copyrightDate encoding="w3cdtf">1993</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">13</extent></physicalDescription><abstract lang="en">Preexcitation After Catheter Ablation. Introduction: The basis for anterograde or retrograde unidirectional block of accessory pathways still remains a controversial issue. Methods and Results: Four of 19 consecutive patients (1 mule, 3 Female; ages 27 to 34 years) who underwent transcatheter ablation of concealed accessory pathways developed manifest preexcitation after the ablation. The location of the concealed accessory pathways in these four patients were right lateral, left posteroseptal, left posterolateral, and left lateral. Radiofrequency current was used in three of the four patients and high energy direct current in one patient. After ablation, manifest preexcitation was observed in these four patients for the first time. Manifest preexcitation developed immediately after ablation in two of the four patients and after 4 and 14 days in the other two. Detailed endocardial mapping revealed that the manifest preexcitation originated from the same location as the concealed pathways. Subsequently, catheter ablation was successfully performed in three of the four patients using radiofrequency current. One patient underwent successful surgical ablation. No recurrence of preexcitation was observed during a follow‐up period of 9 to 38 months. All patients remained free of arrhythmias. Conclusion: The basis for this unexpected emergence of preexcitation in these patients with only retrograde conducting accessory pathways deserves further investigation. Although not compared in the present study, this phenomenon has not been reported in patients who underwent surgical interruption of accessory pathways. We postulate that a lesion at the site of insertion of the accessory pathway had modified the anterograde conduction capacity.</abstract><subject lang="en"><genre>Keywords</genre><topic>accessory pathway</topic><topic>catheter ablation</topic><topic>ventricular preexcitation</topic><topic>concealed accessory pathway</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Cardiovascular Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1045-3873</identifier><identifier type="eISSN">1540-8167</identifier><identifier type="DOI">10.1111/(ISSN)1540-8167</identifier><identifier type="PublisherID">JCE</identifier><part><date>1993</date><detail type="volume"><caption>vol.</caption><number>4</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>467</start><end>472</end><total>6</total></extent></part></relatedItem><identifier type="istex">E08A1D72BFFE1B48D367B8D776D96FC8261D6DA4</identifier><identifier type="DOI">10.1111/j.1540-8167.1993.tb01284.x</identifier><identifier type="ArticleID">JCE467</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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