Zero-fluoroscopy approach for catheter ablation of left-sided slow-fast AVNRT.
 
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1
Subcarpathian Voivodeship Hospital, Krosno, Poland
2
ELMedica EP-Network, Kielce, Poland
3
Dept of Cardiology, Intercard, Nowy Sacz, Poland
4
Chair of Electroradiology, Faculty of Medicine, University of Rzeszow, Rzeszow, Poland
Publish date: 2018-08-01
 
Heart Beat 2018;3:56–58
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ABSTRACT:
Typical slow-fast AV nodal reentrant tachycardia (AVNRT) catheter ablation (CA) of slow pathway (SP) within right-sided triangle of Koch is the golden standard of the procedure. There are, however, rare (1-2%) cases of left-sided AV connections that require different approach to modify the reentry circuit and ablate SP. [1-3] We report a case of slow-fast AVNRT refractory to medical therapy and standard right-sided ablation. Retrograde zero-fluoroscopy (ZF) mapping of septal mitral annulus and left-sided applications achieve noninducibility and no-recurrences. To our knowledge this is the first case report of zero-fluoroscopy ablation of left septal slow-fast AVNRT. Moreover, use of ZF approach for routine, daily practice without intracardiac echocardiography requires expertise in retrograde mapping within mitral annulus substrate.
CORRESPONDING AUTHOR:
Aleksandra Świętoniowska-Mścisz   
Subcarpathian Voivodeship Hospital, Krosno, Poland, ul. M. Curie-Skłodowskiej 2, 37-100 Łańcut, Poland
eISSN:2543-6333