MULTIPLE PATHWAY TACHYCARDIAS - ELECTROPHYSIOLOGICAL PROPERTIES AND FULGURATION OF ACCESSORY PATHWAYS IN 2 PATIENTS

We report two patients (male, 35 and female, 28 years old) with recurr ent and refractory tachycardias referred for an alectrophysiological s tudy. EKG showed left lateral accessory pathway in both, two tachycard ias with identical morphology but with different frequency and activat ion sequence were detected. One was orthodromic with anterograde condu ction by the His-Purkinje budle and retrograde by the accesory pathway and the other with slow nodal anterograde conduction. The accesory pa thway was first fulgurated with radiofrequency at the third attempt. P osteriorly, a nodal reentry tachycardia was induced in the first patie nt and in the second, a double nodal pathway was confirmed. In both, t he slow pathway was modified using Jackman's technique, after three an d four attempts respectively. After these applications, the induction of tachycardia with programmed atrial or ventricular stimulation, with or without Isoproterenol, was not possible It is concluded that radio frequency fulguration is a reasonable therapeutic alternative for pati ents with multiple circuit tachycardias