부산대학교 도서관

We describe a case of concealed WPW syndrome which was successfully treated by radiofrequency catheter ablation via patent foramen ovale. A 52 year-old female was scheduled for radiofrequency catheter ablation due to paroxysmal supraventricular tachycardia. During electrophysiological study, a patent foramen ovale was disclosed. Ventricular pacing demonstrated retrograde atrial activation with earliest activation in the distal coronary sinus, indicating a left lateral accessory pathway. Early ventricular extrastimulation easily induced orthodromic AV reentry utilizing retrograde conduction over the accessory pathway. An ablation catheter was passed to the left atrium through the patent foramen ovale, and the left-sided accessory pathway was successfully ablated at its atrial attachment. An approach from a patent foramen ovale should be attempted for left-sided accessory pathways when it is detected on preoperative echocardiography or during electrophysiological study.