Successful ablation of a right epicardial accessory pathway via the right ventricular diverticulum in a patient with Wolff‐Parkinson‐White syndrome

Abstract

AbstractIntroductionWe describe one rare case of successful ablation of a right epicardial accessory pathway (AP) via the right ventricular diverticulum in a patient with Wolff‐Parkinson‐White syndrome.MethodsA 42‐year‐old woman was referred to the hospital for a catheter ablation of Wolf‐Parkinson‐White syndrome. The earliest activation was shown to be present in the region of the tricuspid annulus. However, ablation had no effect on the AP.ResultsWe decided to do a selected angiography, in which a big diverticulum near the right tricuspid annulus was shown to be present. Ablation in this region successfully repressed the AP without any recurrences within a follow‐up period of 12 months.ConclusionThe ventricular diverticulum‐mediated AP is a novel variant of pre‐excitation. It can serve as an anatomical substrate of supraventricular tachycardia, and can be ablated endocardially using an irrigation tip catheter within the diverticulum.