Manifest accessory pathway

By
Dr. Anwer Alzurfi

Under Supervision of

Dr. Mervat Abol Maaty

Professor of Cardiology/ Electrophysiology
Faculty of Medicine / Ain Shams University
 Case presentation

Thirty eight year old male, smoker with

recurrent attack of palpitation for 7 years, sudden
in onset and offset, fast regular without
exacerbating factors, previously underwent two
ablation.
Resting ECG
Localization of AP
Holter
ECHO
 Procedure
Quadripolar catheter was placed via the right
femoral vein puncture to the RV apex

Decapolar catheter was placed via the left

subclavian vein puncture to coronary sinus.
EP study
Tachycardia
Initiation of tachycardia
Absence of pre-exitation during tachycardia
What is the diagnosis
LAO
RAO
Before starting the ablation
During ablation
AF after ablation, what is the new??
What are the expected
features of ECG post
ablation
ECG Post ablation
Thanks