Gated blood-pool SPECT evaluation of changes after radiofrequency catheter ablation of accessory pathways
Evidence for persistent ventricular preexcitation despite successful therapy
Philippe Chevalier, MD, PhD*,
Laurence Bontemps, PhD ,
Marjaneh Fatemi, MD*,
Stephane Velon, MD*,
Eric Bonnefoy, MD*,
Gilbert Kirkorian, MD*,
Roland Itti, MD and
Paul Touboul, MD*
* Service de Cardiologie et Soins Intensifs, BP Lyon-Montchat 69394 Lyon Cedex 03, France
Service de Médecine Nucléaire Hôpital Cardiovasculaire et Pneumologique Louis Pradel, BP Lyon-Montchat 69394 Lyon Cedex 03, France
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Figure 1 Tomography before (A, B) and after RF ablation (C, D) of a left sided bypass tract. Panels A, C and B, D represent the left and the right ventricle, respectively. There is a phase difference between left (A) and right ventricle (B) that disappeared after ablation. However, we note that the preexcitation zone is anterolateroapical before RF and produces clear preexcitation in the left ventricle, whereas after RF, there is a persistence of a small abnormal early ventricular conduction zone in the apicolateral part (arrow).
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Figure 2 Tomography before (A, B) and after (C, D) catheter ablation in a patient with a right sided accessory pathway. Panels A, C and B, D represent the left and the right ventricle, respectively. There is a phase difference between left (A) and right ventricle (B) that disappeared after ablation. However, after this radical cure, a small preexcitation zone persists in the right ventricle (arrow), although the delta wave has completely disappeared from the ECG.
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