Features of accessory pathways in adult Ebstein's anomaly
Open accessAbstract
AIMS: The aim of the study was to describe the complex electrophysiological features of accessory pathways (APs) in adult Ebstein's anomaly (EA). METHODS AND RESULTS: We performed a retrospective study of 17 consecutive adult EA cases with APs who underwent electrophysiological study and radiofrequency catheter ablation (RFCA) from November 2011 to May 2013. There were a total of 24 atrioventricular reentrant tachycardias (AVRTs) due to 23 APs, including 20 (87.0%) non-decremental conducting, 2 (8.7%) decremental conducting, and 1 (4.3%) nodofascicular bundle. Six (6/17 = 35.3%) patients had two APs while others had only one. Twenty-one APs (91.3%) in 15 patients were manifested and 2 APs (8.7%) in 2 patients were concealed. Six APs (26.1%) were broad, while 17 APs (73.9%) were narrow in width. Two patients suffered from duodromic tachycardias mediated by two APs. Accessory pathways were mainly located on the posterior, posteroseptal, and posterolateral tricuspid annulus (TA). Right ventriculography confirmed that all APs were located on the anatomic TA. All the patients remained free from tachycardias during 11.9 ± 6.8 months of follow-up after RFCA. For the 15 patients with manifest APs, 10 patients' electrocardiograms (ECGs) after RFCA demonstrated morphologies of right bundle branch block, while 5 patients' ECGs were normal. CONCLUSIONS: Accessory pathways in EA are predominantly right-sided, manifest and localize to the lower half of the anatomic TA. A number of APs in EA have broad widths. The incidence of multiple APs is high in these patients and RFCA is effective.
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In Ebstein's anomaly, accessory pathways are frequent (15-30%), more often right sided and multiple than in other patients.
“In Ebstein's anomaly, accessory pathways are frequent (15 -30%) more often right sided and multiple than in other patients, 383 and other SVTs that can occur include AF, AFL and focal AT.”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [383]
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- Authors
- Wei, W., Zhan, X., Xue, Y., Fang, X., Liao, H., Deng, H., Liang, Y., & Wu, S.
- Affiliations
- Guangdong General Hospital (CN)
- Corresponding author
- Wu, S.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-03-09
- Volume
- 16
- Issue
- 11
- Pages
- 1619-1625
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2105243001
- Cited by
- 55
- References
- 21
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 8 · 2020: 2 · 2019: 7 · 2018: 10 · 2017: 6 · 2016: 5 · 2013: 1
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cedars-Sinai Medical Center
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- Ebstein's anomaly, accessory pathway, atrioventricular reentrant tachycardia, radiofrequency catheter ablation, tricuspid annulus, multiple accessory pathways, right bundle branch block, adult congenital heart disease
- MeSH terms
- Adolescent, Adult, China, Ebstein Anomaly, Electrocardiography, Female, Humans, Male, Middle Aged, Retrospective Studies, Tachycardia, Atrioventricular Nodal Reentry, Time Factors, Treatment Outcome, Catheter Ablation, Electrophysiologic Techniques, Cardiac, Young Adult, Accessory Atrioventricular Bundle
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