Successful Epicardial Ablation of a Right Infero-paraseptal Accessory Pathway Presenting as Ventricular Fibrillation.
Gaurav Lakhani, Daljeet Kaur, Sachin Yalagudri et al.
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Case in brief
A 22-year-old man experienced aborted sudden cardiac arrest due to ventricular fibrillation linked to a right inferoparaseptal accessory pathway. Previous ablation attempts were unsuccessful. A repeat electrophysiology study revealed diffuse early activation on endocardial mapping but identified a focal earliest site during epicardial mapping. Successful ablation was achieved with careful catheter positioning, abolishing accessory pathway conduction within 4.9 seconds.
Diagnostic / clinical pearl
This case underscores the necessity of thorough electroanatomic mapping and detailed electrogram analysis in the successful ablation of accessory pathways.
Why it matters
It emphasizes the importance of procedural safety, particularly in catheter positioning to avoid complications during epicardial ablation.