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Accessory Pathway Ablation during Atrial fibrillation in Ebstein Anomaly: Benefits of Intracardiac Echocardiography and 3D intracardiac electrograms visualisation
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  • Taro Miyamoto,
  • Yasushi Oginosawa,
  • Keishiro Yagyu,
  • Yamagishi Yasunobu,
  • Keita Tsukahara,
  • Hisaharu Ohe,
  • Ritsuko Kohno,
  • Haruhiko Abe,
  • Masaharu Kataoka
Taro Miyamoto
University of Occupational and Environmental Health Japan
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Yasushi Oginosawa
UOEH

Corresponding Author:y-ogi@med.uoeh-u.ac.jp

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Keishiro Yagyu
University of Occupational and Environmental Health Japan
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Yamagishi Yasunobu
University of Occupational and Environmental Health Hospital
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Keita Tsukahara
University of Occupational and Environmental Health Japan
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Hisaharu Ohe
University of Occupational and Environmental Health Japan
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Ritsuko Kohno
UOEH
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Haruhiko Abe
UOEH
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Masaharu Kataoka
University of Occupational and Environmental Health Japan
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Abstract

An 84-year-old woman with type B WPW with Ebstein anomaly was admitted with heart failure. She had rapid wide QRS tachcardia due to accessory pathway conduction associated with atrial fibrillation (AF). Since transesophageal echocardiography before catheter ablation showed a left atrial thrombus, ablation was performed using a 3D mapping system under AF. After marking the functional tricuspid anulus with intracardiac echocardiography, three dimensional intracardiac electrogram visualization (ripple map) during AF enabled clear identification of location of the accessory pathway. After ablation, there was no complication of cerebral infarction and heart failure improved.