Transient left bundle branch block and poor atrioventricular conduction during ablation of accessory pathway at the left ventricle

Kuo-Feng Chiang; Chi-Yen Wang; Jin-Long Huang; Yu-Cheng Hsieh

doi:10.1002/joa3.12440

Transient left bundle branch block and poor atrioventricular conduction during ablation of accessory pathway at the left ventricle

J Arrhythm. 2020 Oct 23;36(6):1092-1095. doi: 10.1002/joa3.12440. eCollection 2020 Dec.

Authors

Kuo-Feng Chiang¹, Chi-Yen Wang², Jin-Long Huang^{2

3}, Yu-Cheng Hsieh^{2

3}

Affiliations

¹ Cardiology Division Asian University Hospital Taichung Taiwan.
² Cardiovascular Center Taichung Veterans General Hospital Taichung Taiwan.
³ Institute of Clinical Medicine, and Cardiovascular Research Institute Department of Medicine School of Medicine National Yang-Ming University Taipei Taiwan.

Abstract

A 56-year-old female with manifest Wolff-Parkinson-White (WPW) syndrome was sent to emergency room because of preexcited atrial fibrillation (AF) and became sinus rhythm after cardioversion. Then, she received catheter ablation of a left-sided lateral accessory pathway. The patient immediately developed Wenckebach atrioventricular (AV) block and left bundle branch block (LBBB) during the initial ablation. The ECG still showed LBBB 1 hour after ablation. The LBBB became narrow QRS (The QRS complex in the electrocardiogram. The QRS complex includes the Q wave, R wave, and S wave) 1 day later. Two weeks later, Holter's ECG showed normal sinus rhythm with 1:1 AV conduction even at the maximum heart rate of 125 beats/min. Transient LBBB and poor AV nodal conduction could occur during ablation by the trans-aortic approach.

Keywords: Trans‐aortic approach; Wolff‐Parkinson‐White syndrome; atrioventricular node; catheter ablation; left bundle branch block.

Publication types

Case Reports