Figure 2: Positive adenosine test – Concealed AP
Part A – With ventricular pacing done after ablation of concealed left
lateral accessory pathway, there is concentric atrial activation.
Part B - After administration of iv Adenosine, there is transient
eccentric atrial activation with 3:1 VA conduction suggesting retrograde
pathway conduction - positive adenosine test. From top to bottom, I, and
V1 represents leads I, and V1 of 12 lead surface ECG. LA represents
distal bipole of quadripolar catheter in LA. His d represents distal
bipole of quadripolar catheter in His bundle position. CS p, CS m and CS
d represent proximal, mid, and distal bipole of a decapolar catheter in
coronary sinus, respectively. RVd represent distal bipole of the
catheter in right ventricular apex