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Two decades of experience on ablation in children with Ebstein’s anomaly

Part of: Electrophysiology

Published online by Cambridge University Press:  21 June 2021

Tevfik Karagöz ,
İlker Ertuğrul Open the ORCID record for İlker Ertuğrul [Opens in a new window] ,
Ebru Aypar Open the ORCID record for Ebru Aypar [Opens in a new window] ,
Aydın Adıgüzel ,
Hayrettin Hakan Aykan ,
Murat Şahin ,
Işıl Yıldırım Baştuhan ,
Dursun Alehan  and
Alpay Çeliker
Tevfik Karagöz
Affiliation:
Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara, Turkey
İlker Ertuğrul*
Affiliation:
Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara, Turkey
Ebru Aypar
Affiliation:
Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara, Turkey
Aydın Adıgüzel
Affiliation:
Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara, Turkey
Hayrettin Hakan Aykan
Affiliation:
Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara, Turkey
Murat Şahin
Affiliation:
Department of Paediatric Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Centre and Research Hospital, Istanbul Saglik Bilimleri University, Istanbul, Turkey
Işıl Yıldırım Baştuhan
Affiliation:
Department of Paediatric Cardiology, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey
Dursun Alehan
Affiliation:
Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara, Turkey
Alpay Çeliker
Affiliation:
Department of Paediatric Cardiology, American Hospital, İstanbul, Turkey
*
Author for correspondence: Ilker Ertuğrul, MD, Department of Paediatric Cardiology, Hacettepe Universty Ihsan Dogramacı Children’s Hospital, Ankara 06230, Turkey. Tel: +903123051157. E-mail: [email protected]
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Abstract

Introduction:

Accessory pathways are commonly seen due to delamination of tricuspid valve leaflets. In addition to accessory pathways, an enlarged right atrium due to tricuspid regurgitation and incisional scars creates substrates for atrial re-entries and ectopic tachycardia. We sought to describe our experience with catheter ablation in children with Ebstein’s anomaly.

Methods and results:

During the study period, of 89 patients diagnosed with Ebstein’s anomaly, 26 (30.9%) of them who underwent 33 ablation procedures were included in the study. Accessory pathways were observed in the majority of procedures (n = 27), whereas atrial flutter was observed in five, atrioventricular nodal reentrant tachycardia in five, and atrial tachycardia in two procedures. Accessory pathways were commonly localised in the right posteroseptal (n = 10 patients), right posterolateral (n = 14 patients), septal (n = two patients), and left posteroseptal (n = one patient) areas. Multiple accessory pathways and coexistent arrhythmia were observed in six procedures. All ablation attempts related to the accessory pathways were successful, but recurrence was observed in five (19%) of the ablations. Ablation for atrial flutter was performed in five patients; two of them were ablated successfully. One of the atrial tachycardia cases was ablated successfully.

Conclusions:

Ablation in patients with Ebstein’s anomaly is challenging, and due to nature of the disease, it is not a rare occasion in this group of patients. Ablation of accessory pathways has high success, but also relatively high recurrence rates, whereas ablation of atrial arrhythmias has lower success rates, especially in operated patients.

Keywords

Ebstein’s anomalyablationpaediatric
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 3 , March 2022 , pp. 437 - 443
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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