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Abstract

Objective: The aim of the study was to evaluate localization and ablation ofaccessory pathways based on electrophysiological study (EPS).Methodology: This is a hospital based prospective study conducted inCardiology depar tment Hayatabad Medical Complex (HMC) andElectrophysiology laboratory (EP Lab) in Lady Reading Hospital (LRH) Peshawarfrom September 2006 to December 2012. All adult patients with palpitation, presyncope/ near syncope, syncope, drop attack and dyspnea related to arrhythmias were included. Patient underwent EP study.Results: During this period, 570 patients underwent EPS, 200(35%) of them foraccessory pathways. The mean age of patients underwent EPS for accessorypathways was 33.14±10 years (20-49 years). Males were 102(51%). All thepatients were symptomatic and most common symptom was paroxysmalpalpitation, reported in 174(87%) cases. Delta wave was recorded in 130(65%)and the remaining have concealed pathways. Structurally normal heart wasreported in 190(95%) cases. Left lateral (LL) pathway was most frequent, foundin 108(54%) cases. Postero-septal (PS) pathway in 52(26%), right free wall(RFW) was found in 24(12%), right antero-septal (RAS) pathway in 10(5%) andthe remaining 6(3%) were miscellaneous, including multiple pathways. About190(95%) of these pathways were successfully ablated.Conclusion: Accessory pathway is a common diagnosis among patientsundergoing EP study. Delta waves were common finding on ECG, left lateralpathway was the most frequent findings and trasseptal approach was used inmajority of the cases. Ablation was highly successful irrespective of the types ofpathways and approaches, with no complications.