Review

. 2020 Dec;12(4):555-566.

doi: 10.1016/j.ccep.2020.08.003. Epub 2020 Sep 24.

Ablation of Accessory Pathways with Challenging Anatomy

Jacopo Marazzato¹, Raffaella Marazzi², Fabio Angeli³, Manola Vilotta², Giuseppe Bagliani⁴, Fabio M Leonelli⁵, Roberto De Ponti⁶

Affiliations

¹ Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy; Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy.
² Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy.
³ Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy; Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, Via Crotto Roncaccio, 16, Tradate, Varese 21049, Italy.
⁴ Arrhythmology Unit, Cardiology Department, Foligno General Hospital, Via Massimo Arcamone, Foligno, Perugia 06034, Italy; Cardiovascular Disease Department, University of Perugia, Piazza Menghini 1, Perugia 06129, Italy.
⁵ Cardiology Department, James A. Haley Veterans' Hospital, University of South Florida, 13000 Bruce B Down Boulevard, Tampa, FL 33612, USA; University of South Florida, 4202 East Fowler Avenue, Tampa, FL 33620, USA.
⁶ Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy; Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy. Electronic address: roberto.deponti@uninsubria.it.

PMID: 33162003
DOI: 10.1016/j.ccep.2020.08.003

Review

Ablation of Accessory Pathways with Challenging Anatomy

Jacopo Marazzato et al. Card Electrophysiol Clin. 2020 Dec.

. 2020 Dec;12(4):555-566.

doi: 10.1016/j.ccep.2020.08.003. Epub 2020 Sep 24.

Authors

Jacopo Marazzato¹, Raffaella Marazzi², Fabio Angeli³, Manola Vilotta², Giuseppe Bagliani⁴, Fabio M Leonelli⁵, Roberto De Ponti⁶

Affiliations

¹ Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy; Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy.
² Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy.
³ Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy; Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS, Via Crotto Roncaccio, 16, Tradate, Varese 21049, Italy.
⁴ Arrhythmology Unit, Cardiology Department, Foligno General Hospital, Via Massimo Arcamone, Foligno, Perugia 06034, Italy; Cardiovascular Disease Department, University of Perugia, Piazza Menghini 1, Perugia 06129, Italy.
⁵ Cardiology Department, James A. Haley Veterans' Hospital, University of South Florida, 13000 Bruce B Down Boulevard, Tampa, FL 33612, USA; University of South Florida, 4202 East Fowler Avenue, Tampa, FL 33620, USA.
⁶ Department of Heart and Vessels, Ospedale di Circolo, Viale Borri, 57, Varese 21100, Italy; Department of Medicine and Surgery, University of Insubria, Viale Guicciardini, 9, Varese 21100, Italy. Electronic address: roberto.deponti@uninsubria.it.

PMID: 33162003
DOI: 10.1016/j.ccep.2020.08.003

Abstract

Although catheter ablation of accessory pathways is deemed highly safe and effective, peculiar location of these pathways might lead to complex and potentially hazardous procedures requiring ablation in anatomic regions such as para-Hisian area, coronary sinus, and epicardial surface. The electrophysiologist should know these possible scenarios to plan the best strategy for safe and effective ablation of these uncommon accessory pathways.

Keywords: Atrioventricular accessory pathways; Atrioventricular node; Catheter ablation; Coronary sinus diverticulum; Dilated cardiomyopathy; Epicardial ablation; His bundle; Hypertrophic cardiomyopathy.

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Conflict of interest statement

Conflicts of interest disclosure Dr. R. De Ponti has received lecture fees from Biosense Webster and Biotronik; educational grants from Biosense Webster, Biotronik, Medtronic, Abbott, Boston Scientific, Bayer, Pfizer, Boehringer Ingelheim; and research grants from Actelion. None for the other authors.

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Ablation of Accessory Pathways with Challenging Anatomy

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Ablation of Accessory Pathways with Challenging Anatomy

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