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).
The experience of patients with EA and WPW syndrome who had undergone ablation were intended to be presented by the review.
The ablation performed between 2015 and 2020 on EA and WPW syndrome patients were analyzed in a retrospective review.
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.
The acute success rates of ablation in WPW syndrome and EA patients can be improved significantly by the use of electroanatomical mapping and ICE.