Radiofrequency Current Catheter Ablation of Accessory Atrioventricular Pathways in Ebstein's Anomaly

Abstract

In patients with Ebstein's anomaly and reentrant atrioventricular tachycardias, factors likely to account for failure of RF catheter ablation include an AP located along the atrialized right ventricle and the abnormal morphology of endocardial activation potentials generated in this region.

Coronary Artery Stenosis After Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways in Children With Ebstein’s Malformation

“…20,21 The number of RFC applications as well as the cumulative energy applied to our 2 patients are well within the range reported for ablation procedures in patients with Ebstein's disease. 20 …”

“…20,21 Multiple APs are common in these patients. Even at centers with much experience, primary failure rates of RFC ablation in patients with Ebstein's disease reach 24%, 20 combined with significant recurrence rates.…”

“…20,21 Multiple APs are common in these patients. Even at centers with much experience, primary failure rates of RFC ablation in patients with Ebstein's disease reach 24%, 20 combined with significant recurrence rates. 20,21 The number of RFC applications as well as the cumulative energy applied to our 2 patients are well within the range reported for ablation procedures in patients with Ebstein's disease.…”

Ebstein's Anomaly—An Overview

“…Poor outcomes are mostly attributed to the presence of broad/multiple accessory pathways caused by faulty formation of the insulating tissues at the atrioventricular junction located around the orifice of the malformed tricuspid valves [65] and it can be ablated at the time of operative repair [66] [67] or valve replacement [68] [69]. More recently, catheterization techniques have been developed to ablate accessory pathways with the use of radiofrequency current [70], but the success in patients with Ebstein's anomaly is not yet as high as in patients with structurally normal heart. Complete heart block is rare in Ebstein's anomaly, but first-degree atrioventricular block as shown in Figure 11 occurs in 42% of patients due to right atrial enlargement and structural abnormalities of the atrioventricular conduction system.…”

Catheter ablation of an elusive accessory pathway in Ebstein's anomaly – Innovative surrogate for electroanatomic mapping

“…Paroxysmal atrioventricular reentrant tachycardia (AVRT) may occur in 25%e30% of patients on account of these manifest and additional concealed accessory pathways. 3,4 We report a case of successful radiofrequency catheter ablation in a patient with Ebstein's anomaly who had earlier undergone two failed attempts.…”