Background:

The presence of multiple accessory pathways (AP) and the complex anatomy make ablation difficult in patients presenting with Wolff Parkinson White syndrome (WPW) and Ebstein Anomaly (EA).

Aim:

The experience of patients with EA and WPW syndrome who had undergone ablation were intended to be presented by the review.

Methods:

The ablation performed between 2015 and 2020 on EA and WPW syndrome patients were analyzed in a retrospective review.

Results:

About 26 patients underwent 30 electrophysiological studies and ablations between 2015 and 2020. 53.8% of the 26 patients were males. The mean age of the group was 20.6 ± 9.1 years. The group was noted with 44.5 ± 17.7% mean tricuspid septal valve attachment.

Half of the 30 patients were performed with electroanatomical mapping, and the other half were conventional studies. Around 10 cases (33.3%) were subjected to intracardiac echocardiogram (ICE). 85.7% acute success rate was noted in the procedures, and recurrence on follow-up was experienced in only 3 (10%) patients. A major complication of the atrioventricular block was encountered in only one patient.

The success of electroanatomical mapping was compared with conventional studies. 93.3% vs. 66.6%, p = 0.068 success was observed with electroanatomical mapping vs. conventional studies. A higher success was observed in the case of electroanatomical mapping than the conventional studies.

Similarly, the acute success of ICE was compared with conventional studies. 100% vs 70%, p = 0.04 success was reported with ICE vs conventional studies. Thus, ICE improved the success significantly than conventional studies.

Multiple accessory pathways were seen in 7 (26.9%) patients. The least frequent position was right lateral 19.2%. A 26.9% incidence was noted for the right posteroseptal, and the right posterolateral location was associated with the highest frequency.

Conclusion:

The acute success rates of ablation in WPW syndrome and EA patients can be improved significantly by the use of electroanatomical mapping and ICE.