Where We Can Find Bypass Tract in Ebstein's Anomaly?; a Case of Successful Ablation of Bypass Tract in Ebstein's Anomaly

In patients with Ebstein's anomaly, the localization of accessory pathways may be impeded by abnormal local electrograms recorded along the atrialized right ventricle and by the presence of multiple accessory pathways. We report a case of 50-year-old man diagnosed with Ebstein's anomaly with Wolff-Parkinson-White syndrome who presented with recurrent palpitations. He was referred to our institution for radiofrequency catheter ablation of paroxysmal supraventricular tachycardia. Transthoracic echocardiography revealed the tricuspid valve displaced into the right ventricle, consistent with Ebstein's anomaly. The electrophysiology study showed a right posterolateral accessory pathway. The optimal ablation site was located not in the atrioventricular line of the atrialized ventricular portion, but in the original atrioventricular line.

Radiofrequency cather ablation of right sided accessory atrioventricular pathway with persistent left superi-or vena cava in 7 patients / 实用医学杂志

Objective To summarize radiofrequency cather ablation (RFCA)of tachycardias with right sid-ed accessory atrioventricular pathway in 7 patients with persistent left superior vena cava (PLSVC). Methods RF-CA for right sided accessory atrioventricular pathway in 7 patients with PLSVC was carried out . Coronary sinus ac-cess was performed through the left subclavian and the left femoral vein respectively. Swartz sheath was used during ablation if neccesary. Results There was no siginificant differences in fluoroscopy time between the left subclavian approach and the left femoral vein approach[(2.8 ± 0.6)min vs (3.2 ± 0.3)min, P>0.05)]. No recurrence of ac-cessory pathway conduction was found during a mean follow-up of (23 ± 11) months. The mean discharging time and fluoroscopy time were (312 ± 67)s and (17 ± 5)min respectively. Conclusions Although RFCA of right sided accessory atrioventricular pathway in patients with PLSVC shows specialities in cather manipulation , mapping and ablation, high successful results can be achieved by experienced physician.