Iatrogenic atrioventricular bypass tract following a Fontan operation for tricuspid atresia.
A 16 year old female with tricuspid atresia had undergone a Fontan operation at four years of age. Two years later she first presented with a narrow complex tachycardia which could only be partially controlled on flecainide in high doses. On electrophysiological study, the tachycardia was found to be due to atrioventricular re-entry within the surgical right atrial to right ventricular outflow tract anastomosis. Radiofrequency ablation at this site abolished the arrhythmia and she is now symptom-free on no medication.
Rosenthal
E
E
Department of Paediatric Cardiology, Guy's Hospital, London.
Bostock
J
J
Gill
J
J
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D005260:Female; D005424:Flecainide / Q000627:therapeutic use; D018729:Fontan Procedure / Q000009:adverse effects*; D006801:Humans; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D018785:Tricuspid Atresia / Q000601:surgery*
D000889:Anti-Arrhythmia Agents; D005424:Flecainide