Intra‐cardiac echocardiography guided catheter ablation of a right posterior accessory pathway in a patient with Ebstein's anomaly

We report a case of Ebstein's anomaly in which radiofrequency catheter ablation of an accessory pathway was successfully performed under intra‐cardiac echocardiography. A 50‐year‐old woman was referred to our hospital for radiofrequency catheter ablation of a paroxysmal supraventricular tachyca...

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Bibliographic Details
Published in:Journal of arrhythmia 2014-12, Vol.30 (6), p.515-518
Main Authors: Shimane, Akira, Okajima, Katsunori, Kiuchi, Kunihiko, Kanda, Gaku, Yokoi, Kiminobu, Teranishi, Jin, Aoki, Kousuke, Chimura, Misato, Yamada, Shinichiro, Taniguchi, Yasuyo, Kawai, Hiroya, Yasaka, Yoshinori, Yokoyama, Mitsuhiro
Format: Article
Language:English
Subjects:
Ablation
Ablation (Surgery)
Accessory pathway
Cardiac arrhythmia
Catheter ablation
Catheters
Ebstein's anomaly
Echocardiography
Electrocardiogram
Electrocardiography
Electrodes
Intra‐cardiac echocardiography
Medical research
Medicine, Experimental
Patients
Success
Tachycardia
Ultrasonic imaging
Veins & arteries
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Summary:We report a case of Ebstein's anomaly in which radiofrequency catheter ablation of an accessory pathway was successfully performed under intra‐cardiac echocardiography. A 50‐year‐old woman was referred to our hospital for radiofrequency catheter ablation of a paroxysmal supraventricular tachycardia. A 12‐lead surface electrocardiogram revealed ventricular pre‐excitation associated with type B Wolff–Parkinson–White syndrome. In the baseline electrophysiological study, an orthodromic atrioventricular reciprocating tachycardia with a right posterior accessory pathway was induced. A phased‐array intra‐cardiac echo probe was positioned in the right atrium to visualize the atrioventricular junction. The key structures for catheter ablation, such as the atrialized right ventricle, atrioventricular junction, and tricuspid valve, were clearly visualized on intra‐cardiac echocardiography. Radiofrequency current was successfully delivered at the atrioventricular junction, where a Kent potential was recorded. During a 6‐month follow‐up period, the patient was free from arrhythmias. The findings in this case suggest that phased‐array intra‐cardiac echocardiography is useful for ablation of right‐sided accessory pathways in patients with Ebstein's anomaly.
ISSN:1880-4276
1883-2148
DOI:10.1016/j.joa.2014.02.002