Successful radiofrequency catheter ablation in a patient with Wolff-Parkinson-White syndrome after unsuccessful surgical repair

Radiofrequency catheter ablation has found wider applications for the treatment of supraventricular and ventricular tachycardias. We present a case report of a 30-year-old woman with a history of Wolff-Parkinson-White syndrome and surgical excision of both septal and paraseptal accessory pathways. Five years post surgery she presented with recurrent supraventricular tachycardia. Subsequently she underwent successful radiofrequency catheter ablation of a right posterior septal accessory pathway. After 1.8 seconds of 20 watts of radiofrequency energy delivered to the right posteroseptal region (coronary sinus os), orthodromic supraventricular tachycardia was terminated. After completion of a full 100 second application, there was no evidence of either manifest or concealed accessory pathways, and no supraventricular tachycardia upon restudy. This study emphasizes the ease and facility of the percutaneous catheter ablation techniques that are now employed as compared to the open chest surgical approach.