Introduction: Radiofrequency catheter ablation (RFCA) of accessory pathways (APs) in Ebstein’s anomaly tends to be tough because of the difficulty of identifying appropriate target sites along the atrialized right ventricle (RV).
Methods: : N/A
Results: A 39 year-old male was admitted with resuscitated ventricular fibrillation. The electrocardiogram on admission showed delta wave, and echocardiography revealed apical displacement of the attachment of the septal tricuspid leaflet. We performed RFCA, which needed large numbers of RF energy applications to abolish APs because of the existence of multiple APs and possibly their complex geometry. On the next day, the delta wave recurred, and we underwent 2nd session. We introduced multipolar basket catheter over the tricuspid valve to cover the atrialized RV, which made the identification of earliest activation site during AP conduction easier. The first RF energy application eliminated the AP conduction successfully.
Conclusions: The multipolar basket catheter enables a simultaneous recording of the local electrograms along with atrialized RV in Ebstein’s anomaly where APs are located with spatial extent. This catheter was useful to decide the optimal ablation sites for elimination of APs.