unintentional resetting phenomenon caused by catheter induced mechanical stimulation of the left anterolateral accessory pathway during orthodromic atrioventricular reciprocating tachycardia
2017
1. Abstract An
80-year-old woman was admitted to our hospital for treatment of paroxysmal
supraventricular tachycardia which had been increased sharply after the
antiarrhythmic drug was decreased. Electrophysiological study demonstrated
orthodromic atrioventricular reciprocating tachycardia via the left
anterolateral accessory pathway with relatively slow concealed conduction,
which we supposed to be a target for catheter ablation. Interestingly, only
while the ablation catheter tip was being placed just on the accessory pathway,
the tachycardia cycle length was occasionally altered with the atrial sequence
advancing forward a little, and the culprit pathway was successfully ablated at
this point. We concluded, based on some electrophysiological findings, that this
phenomenon was caused by electrophysiological mechanism of resetting, certainly
induced by direct mechanical stimulation onto the accessory pathway. 2. Keywords: Accessory Pathway; Atrioventricular Reciprocating
Tachycardia; Mechanical Stimulation; Resetting Phenomenon; Slow Concealed
Conduction
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