Inanç Mehmet Tuğrul, Eryol Namik Kemal, Zencir Cemil
Department of Cardiology, Medicine Faculty of Erciyes University, Kayseri, Turkey.
Turk Kardiyol Dern Ars. 2010 Mar;38(2):125-30.
Ebstein's anomaly (EA) is a malformation of the tricuspid valve characterized by a downward displacement of the septal and often the posterior tricuspid valve leaflets to the atrialized right ventricle. Among all congenital anomalies, EA is the most related malformation with accessory pathways. In 5%-25% of patients with EA, accessory atrioventricular pathways may present on the surface electrocardiogram. Radiofrequency catheter ablation is the first-line treatment of EA patients having supraventricular tachyarrhythmias. The presence of a dysplastic tricuspid annulus and electrically distinguishable atrioventricular activity may complicate radiofrequency catheter ablation of accessory pathway tachycardia in these patients. We present three cases of EA in which accessory pathway tachycardias were successfully ablated, with emphasis on technical difficulties in electrophysiological diagnosis and during radiofrequency ablation.
埃布斯坦畸形(EA)是一种三尖瓣畸形,其特征是间隔瓣叶以及通常后瓣叶向下移位至心房化右心室。在所有先天性畸形中,EA是与旁路关系最为密切的畸形。在5% - 25%的EA患者中,体表心电图可能显示存在房室旁路。对于患有室上性快速性心律失常的EA患者,射频导管消融是一线治疗方法。发育异常的三尖瓣环以及电活动可区分的房室活动的存在,可能使这些患者的旁路性心动过速的射频导管消融变得复杂。我们报告了3例成功消融旁路性心动过速的EA病例,重点阐述了电生理诊断及射频消融过程中的技术难点。