Successful cryoablation of Mahaim tachycardia in a child with Ebstein's anomaly.

Abstract

Mahaim fibers with decremental atrioventricular (AV) node-like conduction properties comprise less than 3 % of accessory pathways. Radiofrequency ablation of right atriofascicular pathways guided by a distinct Mahaim potential detected at the anterolateral to posterolateral tricuspid annulus or in the right ventricular free wall is a safe and highly effective treatment method. The case report presents a 16-year-old boy with Ebstein's anomaly and symptomatic wide complex tachyarrhythmia. The electrophysiologic study and the entire ablation procedure were performed using a three-dimensional mapping system (EnSite Velocity; St. Jude Medical Inc., St. Paul, MN, USA). No fluoroscopy was used during the procedure. Electrophysiologic evaluation demonstrated typical atrioventricular nodal reentrant tachycardia and Mahaim tachycardia with a wide QRS and a left bundle branch block pattern. After Mahaim potential was located at the lateral tricuspid annulus, successful cryoablation was performed with an 8-mm-tip catheter followed by slow pathway ablation to eliminate typical atrioventricular nodal reentrant tachycardia. Cryoablation with an 8-mm-tip catheter can be an alternative treatment option for children with Mahaim tachycardia.

• Authors: Yakup Ergul, Celal Akdeniz, Neslihan Kiplapinar, Volkan Tuzcu
• Journal: Pediatric cardiology (Pediatr Cardiol) Vol. 34 Issue 8 Pg. 1890-5 ( 2013) ISSN: 1432-1971 [Electronic] United States
• PMID: 22806715 (Publication Type: Case Reports, Journal Article)

Topics

• Accessory Atrioventricular Bundle (physiopathology, surgery)
• Adolescent
• Cryosurgery (methods)
• Ebstein Anomaly (complications)
• Electrocardiography
• Humans
• Male
• Pre-Excitation, Mahaim-Type (complications, physiopathology, surgery)