An Electrophysiologic Approach to the Surgical Treatment of the Wolff-Parkinson-White Syndrome

Abstract

The usefulness and limitations of electrode catheter and epicardial mapping techniques in the evaluation of the Wolff-Parkinson-White syndrome are described. In one case epicardial surface mapping was unsuccessful in localizing the accessory connection. However, a septal location was suggested by catheter recording techniques and confirmed by the point at which the surgical incision interrupted the accessory connection. In the second case catheter techniques could not confirm the role of the accessory connection in a re-entrant rhythm. Epicardial mapping of the atrium during PAT confirmed a return route to the atrium over the accessory connection, opposite the point of ventricular pre-excitation during sinus rhythm. In both cases, following surgery, epicardial maps, 12-lead ECGs and catheter recording techniques revealed no evidence of residual pre-excitation.