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Ebstein's anomaly with refractory atrial tachycardia
Guofei Zhang1, Yiming Ni, Qiang Feng
1Department of Cardiovascular Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Acta Cardiologica
|September 8, 2011
Summary
Accessory pathways are common in Ebstein's anomaly, but radiofrequency ablation is often less successful. Surgical resection alongside simultaneous surgery successfully treated a patient with refractory atrial tachycardia.
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Surgery
Background:
- Ebstein's anomaly is a congenital heart condition with a high incidence of accessory pathways (20-30%).
- Radiofrequency ablation (RFA) for accessory pathways in Ebstein's anomaly has lower success rates and higher recurrence than in structurally normal hearts.
Observation:
- A 56-year-old male with Ebstein's anomaly presented with refractory atrial tachycardia.
- Preoperative electrophysiological mapping and RFA failed due to the complex tricuspid valve abnormality.
Findings:
- The patient's atrial tachycardia was refractory to standard ablation techniques.
- Simultaneous surgical correction of the tricuspid valve anomaly and pathway resection was performed.
Implications:
- Surgical intervention may be necessary for complex cases of Ebstein's anomaly with refractory arrhythmias.
- Combined surgical and ablation strategies can offer a definitive treatment for challenging accessory pathway cases.
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