Electrophysiologic study and radiofrequency ablation in patients with intracardiac tumors and accessory pathways: is the tumor the pathway?

ABSTRACT

INTRODUCTION: There is a strong association of cardiac rhabdomyomas with the Wolff-Parkinson-White syndrome. This report describes the results of investigations in two patients with accessory pathway-mediated AV reciprocating tachycardia coexisting with intracardiac tumors. METHODS AND RESULTS: Two patients with intracardiac tumors had mapping of the accessory pathway. Echocardiograms obtained in the electrophysiology laboratory while the ablation catheter was at the site of successful radiofrequency ablation demonstrated a close correspondence between the site of intracardiac tumor and the location of the accessory pathway. CONCLUSIONS: These results lend support to the hypothesis that accessory pathways in patients with intracardiac tumors, such as rhabdomyomas, are not typical Kent bundles, but instead are either part of the intracardiac tumor or are closely related to the tumor. Ablation is possible in at least some patients with accessory pathways associated with intracardiac tumors.