Acta clinica Croatica, Vol. 63. No. 1, 2024.
Book review
https://doi.org/10.20471/acc.2024.63.01.24
Successful ablation of concealed accessory pathway mediated supraventricular tachycardia in a 5-year-old child with Ebstein anomaly
Nikola Krmek
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
*
Vladimir Jegdić
; Mostar University Clinical Hospital, Mostar, Bosnia and Herzegovina
Mirta Rode
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia
* Corresponding author.
Abstract
Here we report a case of a 5-year-old boy with Ebstein anomaly and supraventricular
tachycardia. He was diagnosed with Ebstein anomaly at the age of 3 months during the workup
for afebrile convulsions, and has been followed by a pediatric cardiologist since. Electrocardiography
recorded a small Rr` pattern in V1 on a few occasions, without other abnormalities. At the age of 2.5
years, the first episode of supraventricular tachycardia was recorded and stopped with adenosine. He
was started on atenolol and was asymptomatic until a year later when he presented with the second
recorded supraventricular tachycardia. He was referred to our institution for an electrophysiology
study with ablation. Tachycardia was entrained and all the maneuvers were in accordance with
atrioventricular reentry tachycardia. Tricuspid annulus was mapped during tachycardia. The earliest
atrial signals appeared in the posteroseptal region of the valve, mechanical blocking of the tachycardia
was recorded in that region, and early fractionated signal was present during ventricular retrograde
pacing. The pathway was successfully ablated. Basal electrocardiogram was without change after
ablation and the patient did not experience recurrence of tachycardia during follow-up. This case
shows the efficacy and importance of ablation in Ebstein anomaly, without x-ray or intracardiac
echocardiography.
Keywords
Ebstein anomaly; Tachycardia, supraventricular; Electrophysiology
Hrčak ID:
322763
URI
Publication date:
1.4.2024.
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