Epicardial Accessory Pathway with Insertion into the Left Lateral Atrium in Atrioventricular Reentrant Tachycardia

Case Report

Volume 5, Issue 2

Epicardial Accessory Pathway with Insertion into the Left Lateral Atrium in Atrioventricular Reentrant Tachycardia

Jacob Alexander Powell^1* and Jason Cohen²

¹Texas A&M College of Medicine, Bryan TX, USA
²Clinical Cardiac Electrophysiologist, Baylor Scott and White, College Station TX, USA

^*Corresponding author: Jacob Alexander Powell, Texas A&M College of Medicine, Bryan TX, USA. E-mail: japowell98@gmail.com

Received: January 12, 2025; Accepted: January 26, 2025; Published: February 15, 2025

Citation: Powell JA, Cohen J. Epicardial Accessory Pathway with Insertion into the Left Lateral Atrium in Atrioventricular Reentrant Tachycardia. Case Rep Clin Cardiol J. 2025; 5(2): 150.

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Epicardial Accessory Pathway with Insertion into the Left Lateral Atrium in Atrioventricular Reentrant Tachycardia

Abstract

Atrioventricular reentrant tachycardia (AVRT) typically has an accessory pathway (AP) along the atrioventricular valve annulus during an electrophysiology study (EPS) that is treated with ablation. Some accessory pathways with epicardial components have been described, often requiring pericardial access for epicardial ablation. We present a 53-year-old lady who presented to the clinic with palpitations and was found to have AVRT with a wholly epicardial AP that easily terminated with radiofrequency ablation at the AP insertion site. After ablation, the tachycardia was no longer inducible. This case demonstrates the need to look further afield than the atrioventricular groove when an AVRT does not show an obvious accessory pathway.

Keywords: AVRT; Accessory pathway; Marshall bundle; Electrophysiology study

Article Details

Epicardial Accessory Pathway with Insertion into the Left Lateral Atrium in Atrioventricular Reentrant Tachycardia