CHALLENGE OF THE WEEK See Answer to January 29th Following Question Amit Noheria, MBBS, SM A 64-year-old man with frequent symptomatic premature ventricular complexes is brought to the electrophysiology laboratory for premature ventricular complex ablation. Earliest site of activation during premature ventricular complex is noted at location of ablation catheter (ABL; Figure), a consistent far-field signal 48 ms ahead of onset of QRS. Irrigated radiofrequency ablation (40 watts; 30 mL/min) is performed at this site. What structure could sustain collateral injury during ablation? Figure. Right and left anterior oblique fluoroscopic projections showing the location of the ablation catheter (ABL) at the site of high power radiofrequency ablation. Answer Options A. Left anterior descending coronary artery B. Left circumflex coronary artery C. Right coronary artery D. Atrioventricular node E. Right bundle branch Circ Arrhythm Electrophysiol is available at http://circep. ahajournals.org. © 2018 American Heart Association, Inc. Circ Arrhythm Electrophysiol. 2018;11:e006208. DOI: 10.1161/CIRCEP.118.006208 February 2018 1 Noheria; Challenge of the Week ANSWER TO JANUARY 29th QUESTION C. Accessory pathway (atriofascicular/nodofascicular) is not participatory in the tachycardia Figure 1. Twelve-lead electrocardiogram and intracar- diac electrograms of the tachycardia. There is no change in atrial activation sequence and no change in AA intervals
Circulation: Arrhythmia & Electrophysiology – Wolters Kluwer Health
Published: Feb 1, 2018
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