Ablating the anteroseptal accessory pathway-ablation via the right internal jugular vein may improve safety and efficacy

Michael P. DiLorenzo, Robert H. Pass, Lynn Nappo, Scott R. Ceresnak

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Ablation of anteroseptal accessory pathways have historically been associated with lower success rates and a higher risk of AV nodal injury due to close proximity to the compact AV node. We describe the technique of ablation of anteroseptal APs via the right internal jugular vein (RIJV). Methods: A retrospective analysis of all patients undergoing EP study and ablation at the Children's Hospital at Montefiore from 2008 to 2011 for SVT and/or WPW was performed. All patients less than 21 years of age who underwent ablation from the RIJV for either WPW or a concealed accessory pathway located in the anteroseptal region were included. Results: A total of 16 patients met inclusion criteria and were the subject of this analysis. Twelve patients had WPW (75%) and four had a concealed AP (25%). Ablation was acutely successful in 94% of patients (15/16). In one patient, ablation was deferred due to close proximity to the compact AV node and risk of AV nodal injury. Radiofrequency (RF) was used in 14 patients and cryoenergy in two patients. There was no difference in WB CL pre- and post-ablation (p=0.19). There were no complications encountered. At a mean follow-up of 15±12 months, there were no recurrences. Conclusion: Ablation of APs in the right anteroseptal region can safely and effectively be performed via the RIJV with a success rate of 94%. This technique should be considered for ablation of APs located in the anterior septum.

Original languageEnglish (US)
Pages (from-to)293-299
Number of pages7
JournalJournal of Interventional Cardiac Electrophysiology
Volume35
Issue number3
DOIs
StatePublished - Dec 2012

Fingerprint

Jugular Veins
Safety
Atrioventricular Node
Accessory Atrioventricular Bundle
Ablation Techniques
Wounds and Injuries
Recurrence

Keywords

  • Ablation
  • Anteroseptal accessory pathway
  • Internal jugular vein
  • Pediatric electrophysiology
  • Supraventricular tachycardia
  • Wolff-Parkinson-White syndrome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Ablating the anteroseptal accessory pathway-ablation via the right internal jugular vein may improve safety and efficacy. / DiLorenzo, Michael P.; Pass, Robert H.; Nappo, Lynn; Ceresnak, Scott R.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 35, No. 3, 12.2012, p. 293-299.

Research output: Contribution to journalArticle

DiLorenzo, Michael P. ; Pass, Robert H. ; Nappo, Lynn ; Ceresnak, Scott R. / Ablating the anteroseptal accessory pathway-ablation via the right internal jugular vein may improve safety and efficacy. In: Journal of Interventional Cardiac Electrophysiology. 2012 ; Vol. 35, No. 3. pp. 293-299.
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abstract = "Purpose: Ablation of anteroseptal accessory pathways have historically been associated with lower success rates and a higher risk of AV nodal injury due to close proximity to the compact AV node. We describe the technique of ablation of anteroseptal APs via the right internal jugular vein (RIJV). Methods: A retrospective analysis of all patients undergoing EP study and ablation at the Children's Hospital at Montefiore from 2008 to 2011 for SVT and/or WPW was performed. All patients less than 21 years of age who underwent ablation from the RIJV for either WPW or a concealed accessory pathway located in the anteroseptal region were included. Results: A total of 16 patients met inclusion criteria and were the subject of this analysis. Twelve patients had WPW (75{\%}) and four had a concealed AP (25{\%}). Ablation was acutely successful in 94{\%} of patients (15/16). In one patient, ablation was deferred due to close proximity to the compact AV node and risk of AV nodal injury. Radiofrequency (RF) was used in 14 patients and cryoenergy in two patients. There was no difference in WB CL pre- and post-ablation (p=0.19). There were no complications encountered. At a mean follow-up of 15±12 months, there were no recurrences. Conclusion: Ablation of APs in the right anteroseptal region can safely and effectively be performed via the RIJV with a success rate of 94{\%}. This technique should be considered for ablation of APs located in the anterior septum.",
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