Two decades of experience on ablation in children with Ebstein’s anomaly

2021 ◽  
pp. 1-7
Author(s):  
Tevfik Karagöz ◽  
İlker Ertuğrul ◽  
Ebru Aypar ◽  
Aydın Adıgüzel ◽  
Hayrettin Hakan Aykan ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Atrial Tachycardia ◽  
Ebstein’S Anomaly ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Success Rates ◽  
Recurrence Rates ◽  
Ebstein's Anomaly ◽  
Accessory Pathways ◽  
Rare Occasion ◽  
The Right

Abstract Introduction: Accessory pathways are commonly seen due to delamination of tricuspid valve leaflets. In addition to accessory pathways, an enlarged right atrium due to tricuspid regurgitation and incisional scars creates substrates for atrial re-entries and ectopic tachycardia. We sought to describe our experience with catheter ablation in children with Ebstein’s anomaly. Methods and results: During the study period, of 89 patients diagnosed with Ebstein’s anomaly, 26 (30.9%) of them who underwent 33 ablation procedures were included in the study. Accessory pathways were observed in the majority of procedures (n = 27), whereas atrial flutter was observed in five, atrioventricular nodal reentrant tachycardia in five, and atrial tachycardia in two procedures. Accessory pathways were commonly localised in the right posteroseptal (n = 10 patients), right posterolateral (n = 14 patients), septal (n = two patients), and left posteroseptal (n = one patient) areas. Multiple accessory pathways and coexistent arrhythmia were observed in six procedures. All ablation attempts related to the accessory pathways were successful, but recurrence was observed in five (19%) of the ablations. Ablation for atrial flutter was performed in five patients; two of them were ablated successfully. One of the atrial tachycardia cases was ablated successfully. Conclusions: Ablation in patients with Ebstein’s anomaly is challenging, and due to nature of the disease, it is not a rare occasion in this group of patients. Ablation of accessory pathways has high success, but also relatively high recurrence rates, whereas ablation of atrial arrhythmias has lower success rates, especially in operated patients.

scholarly journals Location of accessory pathways and its radiofrequency ablation in Wolf-Parkinson-White syndrome

2006 ◽  
Vol 134 (9-10) ◽  
pp. 386-392 ◽  
Author(s):  
Dejan Vukajlovic ◽  
Lazar Angelkov ◽  
Aleksandar Neskovic
Keyword(s):  
Radiofrequency Ablation ◽  
Interface Temperature ◽  
Success Rates ◽  
Recurrence Rates ◽  
Accessory Pathways ◽  
First Line Therapy ◽  
Total Procedure Time ◽  
Significant Difference ◽  
Primary Success ◽  
The Right

Introduction: Radiofrequency ablation (RFA) of accessory pathways (AP) is the first line therapy in symptomatic patients with preexcitation syndrome, resistant to medical therapy. Objective: To evaluate the influence of AP location on RFA effectiveness. Method: The study compared RFA results of AP located on the left side, right side, and in septal area of the heart in the first 101 consecutive patients treated at Dedinje Cardiovascular Institute in Belgrade. Results: There was no significant difference between the right-, left- and septal-AP in relation to primary success rates (66.7%, 84.3%, 73.7%, respectively, p=0.285), recurrence rates (12.5%, 6.97%,14.3%, p=0.591), and final success rates (66%, 84.3%, 78.9%, p=0.37). Maximally achieved interface temperature was lowest at right-sided AP (49.8?1.9?C) as compared to the left (53.0?3.5?C) or septal AP (52.9?3.0?C) (p<0.01). Fluoroscopy time did not differ significantly (p=0.062), while total procedure time and the number of applied RF pulses was higher in the left-sided AP as compared to other two (104.6?44.9 for the left, 98.9?47.5 for the right and 80.7?39.8 minutes for the septal AP, p<0.05; 11.0?8.8 pulses for the left, 6.5?3.8 for the right and 6.4?5.0 for septal AP, p<0.01). Two major complications developed: one third-degree AV block after ablation of midseptal AP, and one pericardial effusion without tamponade, with spontaneous regression. Conclusion: The success rate of RFA of the right-, left- and septal-AP was similar. Heating of the tissue was weakest during RFA of the right-sided AP.

Radiofrequency Ablation of Atrial Fibrillation in Patients with Ebstein's Anomaly: A Two-Case Report

Cardiology ◽  
2017 ◽  
Vol 139 (1) ◽  
pp. 33-36 ◽  
Author(s):  
Konstantinos E. Iliodromitis ◽  
Marc Bonsels ◽  
Rolf Borchard ◽  
Anja Dorszewski
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Right Ventricle ◽  
Ebstein’S Anomaly ◽  
Atrioventricular Nodal Reentrant Tachycardia ◽  
Reentrant Tachycardia ◽  
Ebstein's Anomaly ◽  
The Right ◽  
Apical Displacement

Ebstein's anomaly (EA) is a rare congenital heart disease characterized by “atrialization” of the right ventricle, due to apical displacement of the tricuspid leaflets into the right ventricle. Patients with EA may develop all kinds of supraventricular arrhythmias requiring radiofrequency ablation. Atrial fibrillation (Afib) is a common arrhythmia in EA patients, and results in debilitating symptoms that often require surgical treatment. This is a follow-up report of 2 patients with EA undergoing radiofrequency ablation for Afib. The first patient underwent pulmonary vein isolation (PVI) and the ablation of a concomitant atrioventricular nodal reentrant tachycardia. The second patient was also treated with a PVI and a redo PVI 8 months later. Both patients remain in sinus rhythm 8 months on. Radiofrequency ablation is the therapy of choice for patients with pharmacological refractory Afib, but it is not common in patients with EA.

SUCCESSFUL CORRECTION OF EBSTEIN’S ANOMALY CRITICAL FORM COMPLICATED BY THROMBOSIS OF THE RIGHT VENTRICLE IN 10 MONTH-OLD CHILD

2017 ◽  
Vol 96 (1) ◽  
pp. 206-208
Author(s):  
R. R. Movsesyan ◽  
V. A. Bolsunovskiy ◽  
A. V. Bolsunovskiy ◽  
A. L. Tsytko ◽  
D. R. Yamgurov
Keyword(s):  
Right Ventricle ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Critical Form ◽  
The Right

scholarly journals Ebstein’s Anomaly, Left Ventricular Noncompaction and Gerbode-Like Defect Triad (Fetal Diagnosis and Neonatal Course)

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mohammad Mehdi ◽  
Snigdha Bhatia ◽  
Mehul Patel ◽  
Ashraf Aly
Keyword(s):  
Heart Defects ◽  
Fontan Procedure ◽  
Left Ventricular ◽  
Ebstein’S Anomaly ◽  
Left Ventricular Noncompaction ◽  
Fetal Diagnosis ◽  
Ventricular Noncompaction ◽  
Ebstein's Anomaly ◽  
The Right ◽  
Apical Displacement

Ebstein’s anomaly is characterized by the apical displacement of the septal and posterior leaflets of the tricuspid valve with atrialization of the right ventricle (RV). It is commonly associated with other heart defects including left ventricular noncompaction. We describe a case of prenatally diagnosed Ebstein’s anomaly in association with left ventricular noncompaction and a septal defect between the left ventricle and the atrialized portion of the RV (Gerbode-like defect). The patient underwent a modified Blalock−Taussig shunt followed by Glenn procedure because of severe RV hypoplasia and RV outflow tract obstruction. The patient tolerated both procedures and is doing clinically well in anticipation of Fontan procedure for single ventricle palliation.

scholarly journals A clinical case of repeated correction of Ebstein’s anomaly using the ‘cone reconstruction’ method

2020 ◽  
Vol 24 (2) ◽  
pp. 102
Author(s):  
N. M. Troshkinev ◽  
E. A. Svyazov ◽  
O. V. Mochula ◽  
N. A. Shmakova ◽  
I. V. Ivanova ◽  
...  
Keyword(s):  
Informed Consent ◽  
Conflict Of Interest ◽  
Ebstein’S Anomaly ◽  
Reconstruction Method ◽  
Hemodynamic Parameters ◽  
Resonance Imaging ◽  
Ebstein's Anomaly ◽  
Mean Pressure ◽  
Critical Revision ◽  
The Right

<p>We report the case of a 16-year-old child with Ebstein’s anomaly who successfully underwent recorrection via the ‘cone reconstruction’ method using a tricuspid valve-in-ring implant. Because the patient had high-grade atrioventricular block, a pacemaker was implanted. Ultrasound and magnetic resonance imaging were conducted to determine the anatomy of the right ventricle and its hemodynamic parameters. Echocardiography performed at the time of discharge revealed an improvement in the hemodynamic parameters of the patient after the correction: triuspid valve regurgitation is mild and peak/mean pressure gradient 10/5 mmHg.</p><p>Received 9 January 2020. Revised 16 March 2020. Accepted 17 March 2020.</p><p><strong>Informed consent:</strong> The patient’s informed consent to use the records for medical purposes is obtained.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Drafting the article: N.M. Troshkinev, O.V. Mochula, O.A. Egunov<br />Literature review: N.A. Shmakova, I.V. Ivanova<br />Illustrations: N.M. Troshkinev, O.V. Mochula<br />Critical revision of the article: E.V. Krivoshchekov, E.A. Svyazov<br />Surgical treatment: E.V. Krivoshchekov, O.A. Egunov, N.M. Troshkinev<br />Final approval of the version to be published: N.M. Troshkinev, E.A. Svyazov, O.V. Mochula, N.A. Shmakova, I.V. Ivanova, O.A. Egunov, E.V. Krivoshchekov</p>

Atrial tachycardias: macroreentrant atrial tachycardias, CTI-dependent atrial flutter (clockwise, anticlockwise), and non-CTI-dependent macroreentrant atrial tachycardia

ESC CardioMed ◽  
2018 ◽  
pp. 2075-2082
Author(s):  
Jose L. Merino
Keyword(s):  
Atrial Flutter ◽  
Atrial Tachycardia ◽  
Heart Diseases ◽  
Vena Cava ◽  
Common Type ◽  
Tricuspid Annulus ◽  
Significant Morbidity ◽  
Structural Heart Diseases ◽  
The Right ◽  
Invasive Evaluation

Macroreentrant atrial tachycardia is, after atrial fibrillation, the most common sustained form of supraventricular tachycardia. It is often associated with significant morbidity and mortality. Originally, atrial flutter was the most used term but has been discouraged in favour of the most generally applied macroreentrant atrial tachycardia and the definition and diagnosis changed from an electrocardiogram-based to an electrophysiological one after invasive evaluation. The most common type of macroreentrant atrial tachycardia is cavotricuspid isthmus (CTI)-dependent atrial flutter. The reentrant circuit of CTI-atrial flutter revolves around the tricuspid annulus in the counterclockwise or the less common clockwise direction. The treatment of choice for most presentations of CTI-dependent flutter is catheter ablation by linear radiofrequency application of the isthmus between the tricuspid annulus and the inferior vena cava. Different reentrant circuits of non-CTI-dependent macroreentrant atrial tachycardia have been reported in both the right and the left atrium. They are often associated with different structural heart diseases.

scholarly journals SURGICAL PALLIATION IN PATIENTS WITH EBSTEIN'S ANOMALY AND CONGENITAL HYPOPLASIA OF THE RIGHT VENTRICLE

1960 ◽  
Vol 40 (3) ◽  
pp. 310-320 ◽  
Author(s):  
Milton Weinberg ◽  
Juan P. Bicoff ◽  
Magnus H. Agustsson ◽  
Zwi Steiger ◽  
Benjamin M. Gasul ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Surgical Palliation ◽  
The Right

scholarly journals Wide complex tachycardia in an elderly woman due to Ebstein’s anomaly with two accessory pathways

2019 ◽  
Vol 5 (4) ◽  
pp. 205-208
Author(s):  
Vlad Radulescu ◽  
Joseph Donnelly ◽  
Jonathan Willner ◽  
Stuart Beldner ◽  
Apoor Patel ◽  
...  
Keyword(s):  
Elderly Woman ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Accessory Pathways ◽  
Wide Complex Tachycardia
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