TY - JOUR
T1 - Parahisian pacing
T2 - Technique, utility, and pitfalls
AU - Sheldon, Seth H.
AU - Li, Hung Kei
AU - Asirvatham, Samuel J.
AU - McLeod, Christopher J.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/8
Y1 - 2014/8
N2 - Several observations and maneuvers in the electrophysiology (EP) laboratory are employed to identify whether retrograde ventriculoatrial conduction is via the atrioventricular (AV) node or an accessory pathway. Parahisian pacing is a unique maneuver where there is no change in the position of the catheter, the position of the stimulating electrode, nor the cycle length for pacing, but rather the pacing output is varied. The primary value for parahisian pacing is to distinguish between a septal accessory pathway and AV nodal conduction. However, more nuanced but just as reliable interpretation is possible to also help identify free-wall accessory pathways, intermittently conducting pathways, multiple accessory pathways, and various combinations of pathway and AV nodal retrograde conduction. In this review, we discuss the importance of correct technique and explain with examples some uncommon, yet instructive, findings when performing parahisian pacing.
AB - Several observations and maneuvers in the electrophysiology (EP) laboratory are employed to identify whether retrograde ventriculoatrial conduction is via the atrioventricular (AV) node or an accessory pathway. Parahisian pacing is a unique maneuver where there is no change in the position of the catheter, the position of the stimulating electrode, nor the cycle length for pacing, but rather the pacing output is varied. The primary value for parahisian pacing is to distinguish between a septal accessory pathway and AV nodal conduction. However, more nuanced but just as reliable interpretation is possible to also help identify free-wall accessory pathways, intermittently conducting pathways, multiple accessory pathways, and various combinations of pathway and AV nodal retrograde conduction. In this review, we discuss the importance of correct technique and explain with examples some uncommon, yet instructive, findings when performing parahisian pacing.
KW - Accessory pathway
KW - Concealed accessory pathway
KW - Parahisian pacing
KW - Wolff-Parkinson-White
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U2 - 10.1007/s10840-014-9908-9
DO - 10.1007/s10840-014-9908-9
M3 - Review article
C2 - 25011420
AN - SCOPUS:84905587494
SN - 1383-875X
VL - 40
SP - 105
EP - 116
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 2
ER -