Radiofrequency ablation of tachyarrhythmias in patients with Ebstein's anomaly

Okishige, Kaoru; Azegami, Kouji; Goseki, Yoshinari; Ohira, Hiroshi; Sasano, Tetsuo; Yamashita, Katsuhiro; Satake, Shutaro

doi:10.1016/s0167-5273(97)00089-2

Cited by 15 publications

(14 citation statements)

References 28 publications

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“…There were 5 patients who underwent an arrhythmia treatment before cardiac surgery in our study group (2 with Ebstein's anomaly, 1 with a ventricular septal defect, 1 with aortic stenosis, and 1 with an atrial septal defect). The association between the accessory pathways and Ebstein's anomaly has been well documented in previous reports 16–19 . More than 2 accessory pathways were noted in both of the 2 patients with Ebstein's anomalies in this study.…”

Section: Discussionsupporting

confidence: 87%

The Results of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children

Lee

Hwang

Chen

et al. 2007

Pacing Clinical Electrophis

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Section: Discussionsupporting

confidence: 87%

The Results of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children

Lee

Hwang

Chen

et al. 2007

Pacing Clinical Electrophis

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“…a relatively lower success rate (77.8%) was observed in the children with AT group in our study when compared with the other types of SVT. It is expected that technologic advances such as new mapping systems and increasing experience will improve the acute success rate, shorten the fluoroscopy time, and decrease the complication rate of AT ablation 23,32–35…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency Catheter Ablation in Children with Supraventricular Tachycardias: Intermediate Term Follow up Results

Hafez

Abu-Elkheir

Shokier

et al. 2012

Clin Med Insights Cardiol

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The Purpose of the StudyRadiofrequency (RF) catheter ablation represents an important advance in the management of children with cardiac arrhythmias and has rapidly become the standard and effective line of therapy for supraventricular tachycardias (SVTs) in pediatrics. The purpose of this study was to evaluate the intermediate term follow up results of radiofrequency catheter ablation in treatment of SVT in pediatric age group.MethodsA total of 60 pediatric patients (mean age = 12.4 ± 5.3 years, ranged from 3 years to 18 years; male: female = 37:23; mean body weight was 32.02 ± 12.3 kg, ranged from 14 kg to 60 kg) with clinically documented SVT underwent an electrophysiologic study (EPS) and RF catheter ablation at Children’s Hospital Mansoura University, Mansoura, Egypt during the period from January 2008 to December 2009 and they were followed up until October 2011.ResultsThe arrhythmias included atrioventricular reentrant tachycardia (AVRT; n = 45, 75%), atrioventricular nodal reentrant tachycardia (AVNRT; n = 6, 10%), and atrial tachycardia (AT; n = 9, 15%). The success rate of the RF catheter ablation was 93.3% for AVRT, 66.7% for AVNRT, and 77.8% for AT, respectively. Procedure-related complications were infrequent (7/60, 11.7%), (atrial flutter during RF catheter ablation (4/60, 6.6%); ventricular fibrillation during RF catheter ablation (1/60, 1.6%); transient complete heart block during RF catheter ablation (2/60, 3.3%)). The recurrence rate was 8.3% (5/60) during a follow-up period of 34 ± 12 months.ConclusionRF catheter ablation is an effective and safe method to manage children with SVT.

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“…2,3 Okishige et al reported a case of Ebstein anomaly in which catheter ablation for common atrial flutter was performed; 4 in that case, the atrial flutter cycle length was 312 ms and the flutter waves were wider and deeper on the 12-lead ECG. The unusually slow conduction in the right atrium of the present patient may have been caused by changes in the myocardium, such as fibrosis and dilatation, and the atypical flutter wave possibly resulted from the enlargement and distortion of the atria.…”

Section: Discussionmentioning

confidence: 99%

Ebstein Anomaly Associated With Unusual Conduction Delay and Sick Sinus Syndrome-A Case Report-

Mani

Shirayama

Yamamura

et al. 2004

Circ J

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bstein anomaly is characterized by apical displacement of the septal or posterior leaflet of the tricuspid valve and may be related to abnormal cell death. Furthermore, conduction abnormalities associated with this anomaly are often confined to the atrioventricular junction. We report a rare case of Ebstein anomaly associated with an unusual conduction delay in the whole heart, as well as systolic dysfunction of both ventricles, which indicates that the entire myocardium can be impaired globally in this anomaly. Case ReportA 64-year-old man was admitted to our hospital because he had often felt palpitation and dyspnea on effort, and he had facial edema. On admission, the 12-lead electrocardiogram (ECG) revealed atrial tachycardia with 2:1 conduction and intraventricular conduction delay; his heart rate was 75 beats/min (atrial rate: 150 beats/min) (Fig 1). The cardiothoracic ratio was 61% on chest rentogenogram. Echocardiography showed severe enlargement of the right atrium and ventricle, decreased systolic function of both ventricles (end-diastolic and end-systolic left ventricular dimensions were 48 mm and 41 mm, respectively), apical displacement of the septal leaflet of the tricuspid valve by 16 mm (10.5 mm/m 2 ), and mild tricuspid regurgitation with a peak velocity of 0.78 m/s and pressure gradient of 2.4 mmHg (Fig 2). The diagnosis was Ebstein anomaly.An electrophysiological study revealed that the atrial rhythm was common atrial flutter. Atrial mapping showed a counterclockwise rotation of excitation along the tricusCirculation Journal Vol.68, July 2004 pid annulus; the atrial flutter cycle length was 400 ms (Fig 3). The post pacing interval after an extra-stimulation at the proximal coronary sinus and the low lateral right atrium was the same as the atrial flutter cycle length. Right atrial mapping showed that the slowest atrial conduction existed between RA3 and RA1 (Fig 3), located on the inferior vena cava -tricuspid annulus isthmus where low A 64-year-old man was admitted to our hospital because of palpitation, dyspnea on effort, and facial edema. The echocardiographic diagnosis was Ebstein anomaly. Although the 12-lead electrocardiogram showed an atrial rate of 150 beats/min and no typical flutter wave, the electrophysiological study showed counterclockwise rotation of excitation along the tricuspid annulus. Because of sinus arrest and syncope, a permanent pacemaker was implanted, but the right atrium was not captured by electrical stimulation at 5V/0.4 ms, except for the orifice of coronary sinus, and the intracardiac P wave was only 0.2 mV or less. This is a rare case of Ebstein anomaly characterized by unusually prolonged conduction in the atrium, the basis of which was global myocardial damage, including the ventricles.

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Radiofrequency ablation of tachyarrhythmias in patients with Ebstein's anomaly

Cited by 15 publications

References 28 publications

The Results of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children

The Results of Radiofrequency Catheter Ablation of Supraventricular Tachycardia in Children

Radiofrequency Catheter Ablation in Children with Supraventricular Tachycardias: Intermediate Term Follow up Results

Ebstein Anomaly Associated With Unusual Conduction Delay and Sick Sinus Syndrome-A Case Report-

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