A case of catheter ablation of accessory atrioventricular connection between the right atrial appendage and right ventricle guided by a three-dimensional electroanatomic mapping system

Accessory AV Connection Between RAA and RV. A 12-year-old girl was referred to our institution because of frequent episodes of AV reciprocating tachyc ardia, Ventriculoatrial and AV intervals were relatively long along the tri cuspid annulus, Earliest retrograde atrial activation was recorded at the m id-portion of the right atrial appendage, 7 mm from the tricuspid annulus. The CARTO electroanatomic mapping system was very useful for providing accu rate spatial orientation of the accessory connection. Complete ablation of this connection required multiple radiofrequency energy applications over a n extensive area because of the multicomponent structure of the connection.