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Characteristics of Intracardiac Potentials at Successful Ablation Sites in Concealed Wolff-Parkinson-White Syndrome

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Nobuyuki Sato, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Naka Sakamoto, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Ayumi Yokoyama, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Shinsuke Kamada, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Hiroyuki Kakuchi, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Yasuhito Iida, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

Kenjiro Kikuchi, MD

First Department of Internal Medicine Asahikawa Medical College 4-5-3 Nishikagura Asahikawa 078-8510 Japan

The authors investigated bipolar electrograms recorded from the catheter tip at the actual successful ablation sites in 22 consecutive patients with concealed Wolff-Parkinson-White syndrome to clarify the characteristics of the potentials indicating the optimal site for catheter ablation. In all patients the retrograde transaortic approach to their left-sided accessory pathways, and a temperature-controlled (60°C) energy delivery, were performed. The authors assumed that a shorter dissociation time (time from energy delivery to ventriculoatrial conduction dissociation) indicated more accurate catheter mapping. A significant negative correlation (r = 0.527, p < 0.05) between the AV ratio (ratio of the amplitudes of the atrial to ventricular potentials) recorded at the ablation catheter tip and the dissociation time was observed. When the AV ratio and the dissoci ation time were compared among the groups classified according to the corresponding Npeak (the number of positive potential peaks in the electrogram obtained from the ablation catheter tip during right ventricular apical pacing) value, they differed signifi cantly (p < 0.05 and p < 0.01, respectively), ie, a higher AV ratio and a shorter dissocia tion time related to a multipeak electrogram from the ablation catheter tip. The authors conclude that the atrial insertion site of the accessory pathway, exhibiting a multipeak complex electrogram that may represent nonuniform anisotropic characteristics, is an adequate ablation site.

Angiology, Vol. 50, No. 8, 665-670 (1999)
DOI: 10.1177/000331979905000807


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