Catheter ablation of the parahisian accessory pathways from the aortic cusps-Experience of 20 cases-Improving the mapping strategy for better results

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCHOKR, Muhieddine O.
dc.contributor.authorMOURA, Lucas G. de
dc.contributor.authorAIELLO, Vera D.
dc.contributor.authorSOUSA, Italo B. dos Santos
dc.contributor.authorLOPES, Hugo B.
dc.contributor.authorCARMO, Andre A. L. do
dc.contributor.authorPISANI, Cristiano F.
dc.contributor.authorHARDY, Carina A.
dc.contributor.authorMELO, Sissy L. de
dc.contributor.authorSCANAVACCA, Mauricio I.
dc.date.accessioned2020-08-20T13:29:35Z
dc.date.available2020-08-20T13:29:35Z
dc.date.issued2020
dc.description.abstractIntroduction Catheter ablation of the parahisian accessory pathways (PHAP) has been established as the definitive therapy for this type of arrhythmia. However, the PHAP proximity to the normal atrioventricular conduction system makes the procedure technically challenging. Here, we have reported a case series of 20 patients with PHAP who underwent aortic access ablation to evaluate the safety and efficacy of this approach in the PHAP ablation. Methods and Results The ablation through the aortic cusps was the successful approach in 13 of 20 (65%) of the cases. In 11 patients, the aortic approach was the initial strategy for ablation, and the accessory pathway was eliminated in seven (63.6%) of them. The aortic approach followed a failed right-sided attempt in nine patients. In six (66.7%) patients, the ablation was successful with the aortic approach. The only independent predictor for the successful ablation with each approach was the earliest ventricular activation before delta wave (predelta time) and a right-sided earliest ventricular activation of more than 23 ms had high sensitivity and specificity for right-sided success. Systematically using the two strategies (right and left approaches), the ablation of the PHAP was successful in 18 (90%) patients. Conclusion The aortic approach seems to be a safe and effective strategy for the ablation of PHAP. It can be used when the right-sided approach fails or even considered as an initial strategy when the predelta time is less than 23 ms in the right septal region. When combining the right- and left-sided approaches, the success rate is high. We believe that the retrograde aortic approach remains a key tool for this challenging ablation.eng
dc.description.indexMEDLINEeng
dc.identifier.citationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, v.31, n.6, p.1413-1419, 2020
dc.identifier.doi10.1111/jce.14499
dc.identifier.eissn1540-8167
dc.identifier.issn1045-3873
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/37233
dc.language.isoeng
dc.publisherWILEYeng
dc.relation.ispartofJournal of Cardiovascular Electrophysiology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright WILEYeng
dc.subjectaortaeng
dc.subjectcatheter ablationeng
dc.subjectHis-Purkinje systemeng
dc.subjectPara-Hisian accessory pathwayseng
dc.subjectsupraventricular tachycardiaeng
dc.subjectWolff-Parkinson-White syndromeeng
dc.subject.othercryoablationeng
dc.subject.wosCardiac & Cardiovascular Systemseng
dc.titleCatheter ablation of the parahisian accessory pathways from the aortic cusps-Experience of 20 cases-Improving the mapping strategy for better resultseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.author.externalLOPES, Hugo B.:Univ Sao Paulo, Sch Med, Heart Inst Incor, Sao Paulo, Brazil
hcfmusp.author.externalCARMO, Andre A. L. do:Univ Fed Minas Gerais, Hosp Clin, Belo Horizonte, MG, Brazil; Univ Fed Minas Gerais, Fac Med, Belo Horizonte, MG, Brazil
hcfmusp.citation.scopus7
hcfmusp.contributor.author-fmusphcMUHIEDDINE OMAR CHOKR
hcfmusp.contributor.author-fmusphcLUCAS GOYANNA DE MOURA
hcfmusp.contributor.author-fmusphcVERA DEMARCHI AIELLO
hcfmusp.contributor.author-fmusphcITALO BRUNO DOS SANTOS SOUSA
hcfmusp.contributor.author-fmusphcCRISTIANO FARIA PISANI
hcfmusp.contributor.author-fmusphcCARINA ABIGAIL HARDY
hcfmusp.contributor.author-fmusphcSISSY LARA DE MELO
hcfmusp.contributor.author-fmusphcMAURICIO IBRAHIM SCANAVACCA
hcfmusp.description.beginpage1413
hcfmusp.description.endpage1419
hcfmusp.description.issue6
hcfmusp.description.volume31
hcfmusp.origemWOS
hcfmusp.origem.pubmed32298040
hcfmusp.origem.scopus2-s2.0-85084074904
hcfmusp.origem.wosWOS:000527607100001
hcfmusp.publisher.cityHOBOKENeng
hcfmusp.publisher.countryUSAeng
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hcfmusp.scopus.lastupdate2024-05-10
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