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Temporary, Catheter-Induced Block in Accessory Pathways

SUMMARY Catheter-induced conduction delay or block in the accessory atrioventricular pathway of four patients with the preexcitation syndrome was observed. Block in the accessory pathway occurred during routine catheter placement and lasted from 90 seconds-14 hours.All of the pathways were in locations readily accessible to catheter trauma, located in the right anterior septal/ paraseptal area in three patients, and in the posterior septum near the orifice of the coronary sinus in the fourth. The location of the accessory pathway was confirmed at surgery by endocardial mapping in three of the four patients. The fourth patient did not undergo surgery.These findings suggest the need for caution in performing and interpreting electrode catheter studies which are undertaken to document the presence of accessory pathways.