Turk Kardiyol Dern Ars. 2011; 39(7): 579-583 | DOI: 10.5543/tkda.2011.01551

Successful percutaneous epicardial ablation of an accessory pathway located at the right atrial appendage

Sedat Köse¹, İbrahim Başarıcı², Kutsi Hasan Kabul¹, Cem Barçın^1
1Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey
²Department of Cardiology, Akdeniz University School of Medicine, Antalya, Turkey

In patients with Wolff-Parkinson-White syndrome, difficulty in ablation of accessory pathways is associated with failures and recurrences. Epicardially located accessory pathways may require different management strategies when conventional ablation attempts fail. In particular, an epicardial accessory pathway communicating the right atrial appendage to the right ventricle is an extraordinary situation resulting in difficulties in ablation. Hereby, we report on a challenging case of percutaneous epicardial ablation of an epicardial accessory pathway located at right atrial appendage in a 28-year-old man with Wolff-Parkinson-White syndrome, who had a prior history of unsuccessful endocardial ablation. Percutaneous epicardial ablation may be a viable option obviating the necessity of surgical ablation procedures for difficult ablation cases with epicardial accessory pathways.

Keywords: Atrial appendage, catheter ablation/methods, heart conduction system; tachycardia, supraventricular; treatment failure; Wolff-Parkinson-White Syndrome

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