Document Detail

Radiofrequency ablation of accessory pathways associated with congenital heart disease including heterotaxy syndrome.
MedLine Citation:
PMID:  8249846     Owner:  NLM     Status:  MEDLINE    
Congenital heart disease complicates the management of most accessory pathway-mediated tachycardias and also increases the challenge of radiofrequency ablation. Since 1990, radiofrequency ablation of accessory atrioventricular (AV) pathways has been attempted in 10 patients (age range 3.5 months to 30 years) with congenital heart disease: Ebstein's anomaly (n = 5), heterotaxy with AV discordance (n = 3), tetralogy of Fallot (n = 1) and total anomalous pulmonary venous return (n = 1). Eight patients had manifest Wolff-Parkinson-White syndrome and 2 had concealed pathways. Five patients had multiple pathways including 4 of the 5 with Ebstein's anomaly. Of 16 pathways total, 15 were associated with the tricuspid valve including all pathways in the patients with Ebstein's anomaly and heterotaxy. The His bundle area was identified in all patients and involved an anterior AV node in 2 of 3 with heterotaxy. Ablation was performed on the atrial side of the AV ring in all cases. No instance of AV block was encountered. Complete success was achieved in 6 patients including the 3 with heterotaxy. In 2 patients, manifest preexcitation was eliminated and clinical symptoms were greatly modified. The procedure was transiently successful in 1 patient who later had surgical interruption of the accessory pathway during tetralogy of Fallot repair. Ablation was unsuccessful in 1 patient. Thus, the overall success was 80%.
J C Levine; E P Walsh; J P Saul
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  72     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Sep 
Date Detail:
Created Date:  1994-01-06     Completed Date:  1994-01-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  689-93     Citation Subset:  AIM; IM    
Department of Cardiology, Children's Hospital, Boston, Massachusetts 02115.
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MeSH Terms
Atrioventricular Node / physiopathology,  surgery*
Bundle of His / physiopathology
Catheter Ablation*
Child, Preschool
Ebstein Anomaly / complications,  physiopathology
Follow-Up Studies
Heart Defects, Congenital / complications*,  physiopathology
Situs Inversus / complications*
Tachycardia / complications*,  physiopathology,  surgery*
Wolff-Parkinson-White Syndrome / complications,  physiopathology,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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