The Pediatric Radiofrequency Ablation Registry's Experience with Ebstein's Anomaly

Abstract

In this patient subset, life-threatening arrhythmias and multiple electrophysiologic mechanisms are commonly encountered during RFA. Mild DOTR and a BSA < or = 1.7 m2 predict a higher acute success rate. While acute success rates are relatively high, recurrence is frequent.

Coronary Artery Stenosis After Radiofrequency Catheter Ablation of Accessory Atrioventricular Pathways in Children With Ebstein’s Malformation

“…Even at centers with much experience, primary failure rates of RFC ablation in patients with Ebstein's disease reach 24%, 20 combined with significant recurrence rates. 20,21 The number of RFC applications as well as the cumulative energy applied to our 2 patients are well within the range reported for ablation procedures in patients with Ebstein's disease. 20 …”

“…20,21 Multiple APs are common in these patients. Even at centers with much experience, primary failure rates of RFC ablation in patients with Ebstein's disease reach 24%, 20 combined with significant recurrence rates.…”

Case Report of Symptomatic and Asymptomatic Ebstein’s AnomalyCardiac MR Imaging

“…It has varied clinical symptoms including fatigue, dyspnea, and cyanosis, conduction disturbances (Right bundle-branch block and Wolff-Parkinson-White syndrome) and arrhythmias. 8 The presence of cyanosis depends on the balance between the right and left atrial pressure. Plain chest radiograph depicts box shaped heart which is caused by right atrial enlargement and pulmonary trunk hypoplasia.…”

ACC/AHA/ESC Guidelines for the Management of Patients With Supraventricular Arrhythmias—Executive Summary

“…Of 65 patients reported in the Pediatric Radiofrequency Ablation Registry, short-term success rates ranged from 75% to 89%, depending on pathway location (septal versus free wall); late recurrences occurred in up to 32% of patients. 221 …”