Successful Radiofrequency Current Catheter Ablation of Accessory Atrioventricular Pathway After Tricuspid Replacement in Ebstein's Anomaly

Ai, Tomohiko; Horie, Minoru; Washizuka, Takashi; Albrecht, Carlos A.; Nishimoto, Toshihisa; Obayashi, Kazuhiko; Tsuchiya, Kunihiko; Watanuki, Masato; Sasayama, Shígetake

doi:10.1253/jcj.62.791

Cited by 9 publications

(8 citation statements)

References 6 publications

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“…The registry‐VS subgroup included four patients (prevalence, 0.1%; age, 37.0 [25.8‐47.5] years; men, 3/4) who underwent RFCA for APs at the site of prior VS and were listed in the RFCA registry. The historical‐VS subgroup included five patients (age, 32.0 [20.5‐44.5] years; men, 1/5) who underwent RFCA for APs at the site of prior VS and were described in previously published case reports . The no‐VS group included 196 patients (age, 40.5 [23.0‐54.0] years; men, 114/196) without a history of VS who underwent RFCA for APs during the year leading up to the study at the same electrophysiological laboratory as the patients in the RFCA registry.…”

Section: Resultsmentioning

confidence: 99%

“…To select suitable patients, we retrospectively reviewed the RFCA registry data of patients (age ≥ 15 years) with APs treated between January 2004 and June 2018 at Severance Hospital or Asan Medical Center, which are large‐volume university hospitals in Seoul, Korea; patients who received RFCA for APs at the site of previous VS were included in the registry‐VS subgroup. In addition, we searched the literature for case reports describing patients who received RFCA for APs at the site of previous VS, and included such patients in the historical‐VS group of the total‐VS group. The no‐VS group included patients with structurally normal heart and without a history of VS, who underwent RFCA for APs during the year leading up to the study in the same electrophysiological laboratory as the patients in the registry‐VS subgroup.…”

Section: Methodsmentioning

confidence: 99%

“…The medical records, operation records, echocardiographic reports, electrophysiological reports, intracardiac electrograms and fluoroscopic images stored in the RFCA registry were reviewed. For patients in the historical‐VS group, we carefully reviewed all information included in the published case reports . Major complications were defined as atrioventricular block; cardiac perforation or tamponade; stroke or transient ischemic attack; and vascular access complications such as hematoma, pseudoaneurysm, and arteriovenous fistula that required transfusion or surgical procedures.…”

Section: Methodsmentioning

confidence: 99%

“…However, in patients with valvular heart disease, RFCA of APs is challenging, especially if the AP is located at a valve annulus that has undergone replacement or repair. The optimal strategy for RFCA of APs at the site of prior valve surgery (VS) remains unclear, as very few case reports on this have been published to date . We aimed to clarify the factors associated with successful RFCA for such APs.…”

Section: Introductionmentioning

confidence: 99%

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Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery

Uhm

Kim

Jin

et al. 2019

Journal of Arrhythmia

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Background Radiofrequency catheter ablation (RFCA) for accessory pathways (APs) at the site of prior valve surgery (VS) remains challenging. We aimed to clarify the factors associated with successful RFCA for such APs. Methods Upon reviewing a RFCA registry and previous case reports, we included nine patients who underwent RFCA of APs at the site of prior VS (total‐VS group; age, 34.0 [24.5‐45.0] years; men, 4/9) and 196 patients who underwent RFCA of APs with no history of VS (no‐VS group; age, 40.5 [23.0‐54.0] years; men, 114/196). Electrophysiological features, procedural details, and outcomes were examined. Results Accessory pathway exhibited decremental conduction in four of nine patients in the total‐VS group. The number of RFCA attempts was significantly higher in the total‐VS group than in the no‐VS group (10.0 [4.5‐14.5] vs 2.0 [1.0‐3.0]; P < 0.001). In four patients who underwent mitral VS, successful RFCA was achieved using the transaortic approach, coronary sinus (CS) approach, or bipolar ablation. In three patients who underwent tricuspid VS, successful RFCA was achieved using the above‐prosthetics or trans‐prosthetics approach. In two patients, RFCA failed. The trans‐prosthetics approach and bipolar ablation technique were effective. The transaortic and CS approaches were occasionally effective. The transseptal approach was ineffective. Conclusions Successful RFCA of APs at the site of prior VS can be achieved by detailed mapping of the areas both above and below the prosthetic valve, as well as by ensuring effective radiofrequency energy delivery using various catheter approaches and RFCA techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Radiofrequency catheter ablation of accessory pathways at the site of prior valve surgery

Uhm

Kim

Jin

et al. 2019

Journal of Arrhythmia

View full text Add to dashboard Cite

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“…Only 2 cases of AP ablation after surgical correction of Ebstein's anomaly have previously been reported, and both received bioprosthetic tricuspid valve replacement without plication of the free wall of the ARV or reattachment of the tricuspid valve to the true annulus . Therefore, both these cases encountered the same difficulty, that is, the obscuration of the target electrogram by the fractionated electrogram of the ARV.…”

Section: Discussionmentioning

confidence: 99%