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Revista Colombiana de Cardiología

Print version ISSN 0120-5633

Abstract

OLAYA, Alejandro et al. Open-heart mapping and radiofrequency ablation: a case of refractory ventricular tachycardia in Ebstein’s anomaly. Rev. Colomb. Cardiol. [online]. 2017, vol.24, n.4, pp.408-408. ISSN 0120-5633.  http://dx.doi.org/10.1016/j.rccar.2016.09.005.

Ebstein’s anomaly is a congenital disease characterised by the displacement and adherence of the tricuspid valve. Septal and posterior valves are implanted in lower positions, thus causing tricuspid insufficiency. This condition gradually generates dilation and deterioration of the right ventricular systolic function. It is commonly associated to other conditions, mainly atrial septal defect and accessory pathway arrhythmias. Sudden death occurs in the advanced stages, usually related to episodes of ventricular tachycardia. This report describes a case of Ebstein’s anomaly and arrhythmic storm who underwent ablation of the arrhythmic endo- and epicardial substract in the atrialized portion of the right ventricle, that developed as an intrasurgical complication the perforation of the ventricle, cardiac tamponade and urgent need of surgical repair. During the surgery a second open-heart radiofrequency ablation was conducted with the goal of eliminating potentially late and fragmented remnants in the low voltage area of the scars. Twenty two weeks after the ablation a subcutaneous cardioverterdefibrillator was implanted for secondary prevention of sudden death; in the follow-up after 14 months there were no appropriate therapies of the device.

Keywords : Congenital heart diseases of adults; Tricuspid atresia; Sudden cardiac death; Catheter ablation;Hybrid surgery.

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