Histologic Findings of the Heart and the Conduction System in the First Patient Who Underwent Catheter Ablation

Abstract

This is a detailed pathological examination of the heart including the conduction system (CS) from a 64-year-old male who had catheter ablation of the atrioventricular (AV) junction for intractable atrial fibrillation. This is the world's first human who had this procedure, and who survived 3 years and 8 months, and later died of congestive heart failure. Pathologically, the heart was hypertrophied and enlarged. Histologically, there were chronic inflammatory cells, marked fatty metamorphosis with fibrosis of the atria, the approaches to the AV node, and the AV node, with almost isolation of the node from the atria, and considerable fibrosis of the bundle and bundle branches. In addition, there was fibrosis of the summit of the ventricular septum with chronic inflammatory cells. These represent the sequelae of the ablation procedures. It is not known how much of the pathological findings contributed to the cardiac hypertrophy and impairment of cardiac function.