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Radiofrequency ablation for slow conducting accessory pathway with degressive character

Objectives:To investigate radiofrequency ablation for slow conducting accessory pathway with degressine character. Methods:Electrophysiological study and rediofrequency ablation. Results:Narrow QRS complexes retrograde P waves,the ratio of R P≥P R interval≥1 and in surface ECG retrograde P waves were inversive in Ⅱ,Ⅲ,avF,vertical in avR.The same ecentric atrial activation sequence was shown during right ventricular pacing and tachycardia.Degressive ventriculoatrial conduction with long V A interval. Conclusions:Mapping and ablation must be very careful to look for the point of earliest atrial activation instead of graft VA during tachycardia and ventricular pacing for successful ablation of slow conducting accessory pathway.