Wolff-Parkinson-White and Other Preexcitation Syndromes: Simple to Complex Electrophysiology and Ablation of Accessory Pathways

Preface
Contents
Characteristics, Classification, and Localization of Accessory Pathways
1 Ventricular Pre-excitation Patterns—The Wolff-Parkinson-White (WPW) and Lown-Ganong-Levine (LGL) Syndromes
	1.1 Anatomical and Pathophysiological Considerations
	1.2 The Wolff-Parkinson-White (WPW) Syndrome
		1.2.1 Classification and Conduction Characteristics
		1.2.2 Tachycardias Utilizing Atrioventricular Accessory Pathway Conduction Circus Movement Tachycardias
		1.2.3 Short Decremental Atrioventricular Accessory Pathways
	1.3 The Lown-Ganong-Levine (LGL) Syndrome
	References
2 Electrocardiographic Localization of Atrioventricular Accessory Pathways
	2.1 Preexcited Electrocardiogram for Localizing Atrioventricular Accessory Pathways
	2.2 Preexcited Electrocardiogram of Limited Accuracy for Identifying Pathway Location
		2.2.1 Atypical Ventricular Preexcitation Unmasked in Left Free-Wall Accessory Pathways
		2.2.2 Mild or Latent Ventricular Preexcitation with Limiting Accuracy for Identifying Accessory Pathways
	2.3 Retrograde P Waves During Orthodromic Tachycardia Utilizing Concealed Pathways
	References
3 Preexcitation Patterns—Mahaim Fibres
	3.1 Anatomical and Pathophysiological Considerations
	3.2 Electrocardiographic Characteristics
		3.2.1 Right Anterograde Atriofascicular Pathways
		3.2.2 Left Posteroseptal Anterograde Atriofascicular Pathway
		3.2.3 Right Posteroseptal Anterograde Nodoventricular Pathway
		3.2.4 Right Concealed Nodoventricular Pathway
	References
Electrophysiologic Study, Mapping, and Ablation of Acessory Pathways
4 Electrophysiologic Evaluation and Characteristics of Atrioventricular Accessory Pathways
	4.1 Electrophysiologic Study and Methods
	4.2 Electrophysiologic Characteristics of Atrioventricular Accessory Pathways
		4.2.1 Baseline Recording During Sinus Rhythm
		4.2.2 Programmed Atrial Stimulation During Sinus Rhythm
		4.2.3 Programmed Ventricular Stimulation During Sinus Rhythm
		4.2.4 Induction of Circus Movement Tachycardia
		4.2.5 Programmed Stimulation During Circus Movement Tachycardia (Entrainment, Resetting)
		4.2.6 Ipsilateral Bundle Branch Block During Orthodromic Circus Movement Tachycardia [32, 33]
		4.2.7 Unipolar Coronary Sinus Recordings During Ventricular Stimulation and Orthodromic Circus Movement Tachycardia
		4.2.8 Intravenous Adenosine for Unmasking Accessory Pathway Conduction
	References
5 Mapping and Ablation Approaches for Left-Sided Accessory Pathways
	5.1 Retrograde Transaortic Approach from the Left Ventricular Aspect
	5.2 Left Atrial Approach
		5.2.1 Trans-Septal Approach
		5.2.2 Retrograde Transaortic/transmitral Approach from the Left Atrial Aspect
	5.3 Epicardial Approaches via the Coronary Sinus and Retrogradely from the Aortic Cusps
		5.3.1 Epicardial Approach via the Coronary Sinus
		5.3.2 Retrograde Approach from the Aortic Cusps
	References
6 Electrophysiology, Mapping, and Ablation of Atrioventricular Accessory Pathways
	6.1 Mapping—Overview
	6.2 Left-Sided Atrioventricular Accessory Pathways
		6.2.1 Left Posterolateral, Lateral, and Anterolateral Accessory Pathways
			6.2.1.1 Left Posterolateral Pathways
			6.2.1.2 Left Lateral Pathways
			6.2.1.3 Left Anterolateral Pathways
		6.2.2 Left Posterior Accessory Pathways
	6.3 Septal Atrioventricular Accessory Pathways
		6.3.1 Left Posteroseptal Accessory Pathways
		6.3.2 Left Midseptal Accessory Pathways
		6.3.3 Right Posteroseptal Accessory Pathways
		6.3.4 Right Midseptal Accessory Pathways
		6.3.5 Right Anteroseptal Accessory Pathways
	6.4 Right-Sided Atrioventricular Accessory Pathways
		6.4.1 Right Anterior Accessory Pathways
		6.4.2 Right Lateral Accessory Pathways
		6.4.3 Right Posterolateral Atrioventricular Accessory Pathway
	References
7 Electrophysiology, Mapping and Ablation of Decremental Atrioventricular Accessory Pathways
	7.1 Anterograde and Retrograde Atrioventricular Accessory Pathways
	7.2 Permanent Junctional Reciprocating Tachycardia (PJRT)
	References
Electrophysiology Study, Mapping, and Ablation of Mahaim Fibers
8 Electrophysiologic Evaluation and Characteristics of Mahaim Fibres
	8.1 Electrophysiologic Study and Methods
	8.2 Electrophysiologic Characteristics
	References
9 Electrophysiologic Study, Mapping and Ablation of Mahaim Fibres
	9.1 Mapping and Catheter Ablation—Overview
		9.1.1 Atriofascicular Pathways
		9.1.2 Nodoventricular Pathways
	9.2 Detailed Study, Mapping, and Catheter Ablation
		9.2.1 Right Anterograde Atriofascicular Pathway
		9.2.2 Left Anterograde Atriofascicular Pathway
		9.2.3 Anterograde Right Nodoventricular Pathway
		9.2.4 Concealed Right Nodoventricular Pathway
		9.2.5 Concealed Right Nodofascicular Pathway
	References
Complex Electrophysiology and Ablation
10 Latent Ventricular Preexcitation in Atrioventricular Accessory Pathways
	References
11 Multiple Accessory Pathways
	References
12 Accessory Pathways Coexistent with Atrioventricular Nodal Reentrant Tachycardia
	References
13 Accessory Pathways Coexistent with Atrial Tachycardia or Complicated by Atrial Fibrillation
	13.1 Introduction
	13.2 Accessory Pathway Coexistent with Atrial Tachycardia
	13.3 Accessory Pathway Complicated by Sustained Atrial Fibrillation
	References
14 Accessory Pathways in Coexistent Congenital Heart Diseases
	14.1 Overview
	14.2 Challenges of Catheter Ablation of Accessory Pathways in Congenital Defects
		14.2.1 Surgical Closure of Ventricular Septal Defect
		14.2.2 Persistent Left Superior Vena Cava
		14.2.3 Coronary Sinus Abnormalities
		14.2.4 Ebstein’s Anomaly
		14.2.5 Dextrocardia
		14.2.6 Mustard Repair
		14.2.7 Criss-Cross Heart
		14.2.8 Repair of Tetralogy of Fallot (TOF)
		14.2.9 Brugada Syndrome
	References
15 Troubleshooting Procedures During Ablation
	References
Index