title: Radiofrequency ablation of an accessory pathway in a surgically created atrioventricular Fontan anastomosis: case report and review of previous published cases.
abstract: Supraventricular tachyarrhythmias following the Fontan procedure can be life-threatening. Though most are commonly due to intraatrial reentry, orthodromic reentrant tachycardia may also be present. Atrioventricular accessory pathways may develop across suture lines following right atrial to right ventricular anastomosis in patients with tricuspid atresia. We report a case of a patient who underwent this type of Fontan who developed orthodromic reentrant tachycardia and heart failure. An electrophysiological study revealed the presence of an atrioventricular accessory pathway traversing the Fontan anastomosis suture line. Successful radiofrequency ablation of the accessory pathway led to control of the tachyarrhythmia and improvement of heart failure.
authors.affiliation: Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York, USA. ll202@columbia.edu
authors.forename: L
authors.initials: L
authors.lastname: Liberman
authors.forename: R H
authors.initials: RH
authors.lastname: Pass
authors.forename: M I
authors.initials: MI
authors.lastname: Alfayyadh
authors.forename: A J
authors.initials: AJ
authors.lastname: Hordof
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D018729:Fontan Procedure; D006801:Humans; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000601:surgery*