Noninvasive electrocardiographic imaging (ECGI) of epicardial activation before and after catheter ablation of the accessory pathway in a patient with Ebstein anomaly.

摘要

Ebstein anomaly is characterized by abnormal development of the tricuspid valve with the septal (and often posterior) leaflets of the valve displaced into the right ventricle (RV). The abnormal development of the tricuspid valve often is associated with several conduction abnormalities, including delayed intra-atrial conduction, right bundle branch block (RBBB),and ventricular pre-excitation. Absence of an RBBB pattern during sinus rhythm on a baseline electrocardiogram (ECG) suggests the presence of an atrioventricular (AV) accessory pathway (AP) in patients with Ebstein anomaly. Often, successful catheter ablation of an AP results in a complete or partial RBBB pattern on the postablation 12-lead ECG in 94% of cases. However, changes in the activation of the heart after a successful catheter ablation of AP in a patient with Ebstein anomaly have never been studied with epicardial activation imaging techniques.