Radiofrequency Catheter Ablation of Accessory Pathway in a Patient with Ebstein’s Anomaly and Atrial Septal Defect

Abstract

The authors report the case of a 57-year-old woman with Ebstein’s anomaly and atrial septal defect. She was referred to their hospital for treatment of refractory paroxysmal wide QRS tachycardia. Her 12-leads ECG in sinus rhythm showed ventricular preexcitation of type B Wolff-Parkinson-White syndrome. In a baseline electrophysiological study, a wide QRS tachycardia with right bundle branch block configurations was induced. This tachycardia was orthodromic atrioventricular reciprocating tachycardia with a right inferior accessory pathway. Radiofrequency current was successfully delivered at the inferior site of the atrialized right ventricle. Radiofrequency catheter ablation seems to be useful for supraventricular tachycardia in patients with Ebstein’s anomaly and atrial septal defect.

Get full access to this article

View all access options for this article.

References

Kumar AE , Fyer DC , Mietinen OS , et al : Ebstein’s anomaly: Clinical profile and natural history. Am J Cardiol 28:84-95, 1971.

Kastor JA , Goldreyer BN , Josephson ME , et al : Electrophysiologic characteristics of Ebstein’s anomaly of the tricuspid valve. Circulation 52:987-995, 1975.

Kocheril AG , Rosenfeld LE : Radiofrequency ablation of an accessory pathway in a patient with corrected Ebstein’s anomaly. PACE 17:986-990, 1994.

Cappato R , Schluter M , Weis C , et al : Radiofrequency current catheter ablation of accessory atrioventricular pathways in Ebstein’s anomaly. Circulation 94:376-383, 1996.

Ai T , Horie M , Washizuka T , et al : Successful radiofrequency current catheter ablation of accessory atrioventricular pathway after tricuspid replacement in Ebstein’s anomaly. Jpn Circ J 62:791-793, 1998.