scholarly journals An atriofascicular tract in a girl with Ebstein's anomaly and right bundle block

2018 ◽  
Vol 16 (1) ◽  
pp. 79
Author(s):  
Ye. A. Pokushalov ◽  
A. N. Turov ◽  
P. L. Shugaev ◽  
D. V. Losik ◽  
V. V. Shabanov
Keyword(s):  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Conduction Velocity ◽  
Clinical Case ◽  
Normal Sinus Rhythm ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Accessory Pathways ◽  
Normal Sinus ◽  
Av Conduction

Described in this article is a clinical case of a 14-year girl with Ebstein's anomaly and a complex preexitation syndrome (two atrioventricular pathways and a true atriofascicular Mahaim's tract). The atriofascicular tract was involved in antidromic and orthodromic tachycardias. The Л-wave was absent initially, because the spontaneous right bundle block and the comparable AV conduction velocity imitated a normal sinus rhythm. All accessory pathways were eliminated successfully during catheter ablation.

Abstract 14912: Sotalol-induced Wide Complex Rhythm: What is the Mechanism?

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Albert J Rogers ◽  
Paul J Wang ◽  
Nitish Badhwar
Keyword(s):  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Conduction Time ◽  
Autonomic Tone ◽  
Normal Sinus ◽  
Typical Atrial Flutter ◽  
Atrial Conduction Time ◽  
Idioventricular Rhythm ◽  
History Of

Introduction: Delta waves associated with atrioventricular accessory pathways (APs) may manifest with autonomic tone, heart rate, and rhythm changes. Rarely, drugs like sotalol can block AV nodal conduction, revealing latent WPW, one treatable cause of sudden death. Case report: A 38-year-old man was admitted for sotalol loading due to frequent typical atrial flutter and SVT and a desire to avoid catheter ablation. He had a history of cardiac arrest with adenosine and tachycardia-induced cardiomyopathy. After recovery, cardiac MRI showed a normal heart without scar. Admission 12-lead ECG ( Figure A ) revealed normal sinus rhythm without other abnormality. With administration of sotalol, the patient developed a wide complex rhythm ( Figure B ). Interpretation of the rhythm indicated presence of a latent AP and a repeat ECG ( Figure C ) confirmed manifest preexcitation. After consenting to electrophysiology study, the patient developed a short RP tachycardia ( Figure D ) which terminated with Valsalva. The patient underwent successful catheter ablation of the pathway located at the anterior floor of the coronary sinus body and the cavotricuspid isthmus. Discussion: The differential diagnosis for a wide complex rhythm in this setting includes rate-related aberrancy, idioventricular rhythm, phase 4 aberrancy, and preexcitation from an AP. Shortened and consistent PR intervals in the tracing lead to preexcitation as the only possible mechanism. APs that are capable of anterograde conduction but are not manifest in sinus rhythm are termed latent APs. Conditions that may cause this phenomenon include opposite autonomic effects on the AP and the AV node, increased atrial conduction time, or concealed retrograde conduction into the AP. Sotalol typically increases the retrograde effective refractory period of the AP but has variable anterograde effect. Sotalol has not previously been reported to reveal a latent AP but may have acted through one of the stated mechanisms.

scholarly journals Radiofrequency catheter ablation of accessory pathways in patients with Ebstein’s anomaly: At 8 years of follow-up

2017 ◽  
Vol 24 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Michał Orczykowski ◽  
Paweł Derejko ◽  
Robert Bodalski ◽  
Piotr Urbanek ◽  
Joanna Zakrzewska-Koperska ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Radiofrequency Catheter Ablation ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Accessory Pathways

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.

Point ablation for macro-reentrant ventricular tachycardia associated with Ebstein’s anomaly and pulmonary atresia: a case report

2020 ◽  
pp. 1-3
Author(s):  
Keiko Toyohara ◽  
Yasuko Tomizawa ◽  
Morio Shoda
Keyword(s):  
Ventricular Tachycardia ◽  
Case Report ◽  
Catheter Ablation ◽  
Right Ventricle ◽  
Low Voltage ◽  
Pulmonary Atresia ◽  
Ebstein’S Anomaly ◽  
Ebstein's Anomaly ◽  
Slow Conduction ◽  
Hypoplastic Right Ventricle

Abstract We report a case with Ebstein’s anomaly and pulmonary atresia with sustained monomorphic ventricular tachycardia in a patient without a ventriculotomy history. In the low voltage area between the atrialised right ventricle and hypoplastic right ventricle, there was a ventricular tachycardia substrate and slow conduction. The tachycardia circuit was eliminated by a point catheter ablation at the area with diastolic fractionated potentials.

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