RADIOFREQUENCY CATHETER ABLATION IN FAMILIAL PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA DUE TO ACCESSORY ATRIOVENTRICULAR PATHWAYS

Radiofrequency catheter ablation (RF-CA) has been widely used to cure paroxysmal supraventricular tachycardia (PSVT). However, its use has n ever been reported in familial PSVT caused by an accessory atrioventri cular pathway (AP), which is known as one of the typical familial card iovascular diseases. Two cases of using RF-CA for familial PSVT due to APs are presented, in a brother and sister, supporting a potential ge netic role in the developmental failure to lose the atrioventricular c onnection during fetal life. The sister, a 24-year-old woman, had inte rmittent episodes of palpitation accompanied by chest pain for 2 years . An electrophysiologic study (EPS) confirmed her clinical tachycardia was atrioventricular reentrant tachycardia (AVRT) due to a left later al concealed AP, which was subsequently successfully ablated with RF-C A. The brother, a 22-year-old man, had a 5-year history of paroxysmal palpitation. A resting electrocardiogram showed a right bundle branch block and left axis deviation with a delta wave. During his EPS, AVRT was reproducibly induced and a manifest AP was localized and then abla ted at the left posteroseptal site, resulting in disappearance of the delta wave. PSVT, however, recurred 1 month later and during a repeat EPS the tachycardia was proved to be AVRT due to a right anterior conc ealed AP. The right anterior AP was successfully ablated with RF-CA. B oth patients remained asymptomatic for more than 3 years following the successful ablation procedures.