Left-sided atrioventricular nodal ablation using the transseptal approach: clinico-histopathologic correlation

To our knowledge, prograde access to the left ventricle to perform a left-sided AV node (AVN) ablation has not been reported. We present the case of a patient with Noonan's syndrome and supravalve aortic stenosis who required aortic valve replacement with a mechanical valve. Due to chronic atri...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 1998-07, Vol.9 (7), p.757-760
Main Authors: Fenrich, Jr, A L, Friedman, R A, Cecchin, F C, Kearney, D
Format: Article
Language:English
Subjects:
Adult
Atrial Fibrillation - pathology
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Atrioventricular Node - pathology
Atrioventricular Node - physiopathology
Atrioventricular Node - surgery
Catheter Ablation - methods
Fatal Outcome
Follow-Up Studies
Heart Rate
Heart Septum
Humans
Male
Tachycardia, Supraventricular - pathology
Tachycardia, Supraventricular - physiopathology
Tachycardia, Supraventricular - surgery
Tachycardia, Ventricular - pathology
Tachycardia, Ventricular - physiopathology
Tachycardia, Ventricular - surgery
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Summary:To our knowledge, prograde access to the left ventricle to perform a left-sided AV node (AVN) ablation has not been reported. We present the case of a patient with Noonan's syndrome and supravalve aortic stenosis who required aortic valve replacement with a mechanical valve. Due to chronic atrial fibrillation, a transvenous pacing system was implanted and transcatheter radiofrequency ablation of the AVN was performed. Attempts at right-sided AVN ablation were unsuccessful. Due to the presence of the mechanical aortic valve, a left-sided AVN ablation was performed successfully using the transseptal approach. The patient died suddenly 6 months after the procedure, and the histologic study of the heart is reported.
ISSN:1045-3873
1540-8167
DOI:10.1111/j.1540-8167.1998.tb00962.x