Document Detail

Radiofrequency current catheter ablation of accessory atrioventricular pathways in Ebstein's anomaly.
MedLine Citation:
PMID:  8759079     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In patients with Ebstein's anomaly, localization of accessory pathways (APs) may be impeded by abnormal local electrograms recorded along the atrialized right ventricle and by the presence of multiple APs. The impact of these factors on radiofrequency (RF) current catheter ablation of APs has not been evaluated yet. METHODS AND RESULTS: Twenty-one patients with Ebstein's anomaly and reentrant atrioventricular tachycardias underwent electrophysiological evaluation and subsequent attempts at RF catheter ablation. Thirty-four right-sided APs were found, with 30 located along the atrialized ventricle. Local electrograms in this region were normal in 10 patients but fragmented in 11. Fragmented electrograms prevented the clear distinction between atrial and ventricular activation potentials as well as the identification of AP potentials. Right coronary artery mapping was performed in 7 patients. Abolition of all 26 APs was achieved in the 10 patients with normal local electrograms and in 6 of 11 patients with abnormal electrograms. Right coronary artery mapping allowed AP localization and ablation in 5 patients. In the 5 patients with abnormal electrograms and a total of 8 APs, 6 APs could not be ablated. Unsuccessfully treated patients received antiarrhythmic drugs. During 22 +/- 12 months of follow-up, 5 patients had clinical recurrences, including 4 who had undergone a successful RF procedure. CONCLUSIONS: In patients with Ebstein's anomaly and reentrant atrioventricular tachycardias, factors likely to account for failure of RF catheter ablation include an AP located along the atrialized right ventricle and the abnormal morphology of endocardial activation potentials generated in this region.
R Cappato; M Schlüter; C Weiss; M Antz; D H Koschyk; T Hofmann; K H Kuck
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  94     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-12-11     Completed Date:  1996-12-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  376-83     Citation Subset:  AIM; IM    
Department of Cardiology, St Georg Hospital, Hamburg, Germany.
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MeSH Terms
Action Potentials
Catheter Ablation*
Child, Preschool
Coronary Angiography
Ebstein Anomaly / diagnosis,  physiopathology,  surgery*
Heart Conduction System / surgery*
Neural Pathways / surgery
Reference Values

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