Radiofrequency ablation of an accessory pathway in a patient with corrected Ebstein's anomaly

Ebstein's anomaly of the tricuspid valve has a known association with the Wolff-Parkinson-White syndrome. Radiofrequency ablation has become the treatment of choice for the latter, but there have been no reports of the feasibility of this procedure after tricuspid valve replacement. We present a patient who first exhibited evidence of intermittent preexcitation and associated symptomatic arrhythmia 9 years after tricuspid valve replacement for Ebstein's anomaly, and describe the challenges posed by this case.