Ablation of an atriofascicular accessory pathway with a zero-fluoroscopy procedure

Ablation of an atriofascicular accessory pathway with a zero-fluoroscopy procedure

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A 16-year-old patient with recurrent palpitations and documented left bundle case of whispering angel branch block superior axis wide complex tachycardia underwent an electrophysiological study and ablation with a zero-fluoroscopy procedure.The electrophysiological study showed a decremental antegrade conducting atriofascicular pathway.Three-dimensional CARTO-guided mapping of the tricuspid annulus in sinus rhythm was performed, and a distinct signal corresponding to the accessory pathway potential of the atriofascicular pathway was found in the posterolateral region.By using an SR0 sheath and a 4-mm-tip catheter, radiofrequency application was delivered the official playboy bunny gold rabbit head zippo lighter at this point on the annulus and successfully eliminated conduction through the accessory pathway.